LEG ISCHEMIA FOLLOWING BILATERAL INTERNAL THORACIC ARTERY AND INFERIOR EPIGASTRIC ARTERY HARVESTING

There is increasing evidence that the use of arterial conduits for cor onary artery bypass grafting provides superior long-term results when compared to using saphenous veins alone. Major complications of using internal thoracic arteries (ITAs) and inferior epigastric arteries (IE As) are uncommon. We report the case of a 42-year-old man who underwen t coronary revascularisation in which harvesting of these arteries res ulted in critical ischaemia of the lower limbs requiring aortobifemora l grafting. This patient had a long-standing occluded abdominal aorta which was asymptomatic and relied on the ITAs and IEAs as important co llateral blood supply to the legs. The enormous size of these conduits found at operation suggested their role. Management strategies to avo id such a serious complication are discussed.