LIMA Conduit Superiority for LAD Bypass
This question asks for the primary reason why the Left Internal Mammary Artery (LIMA) is the preferred choice as a bypass conduit for the Left Anterior Descending (LAD) artery during Coronary Artery Bypass Grafting (CABG).
Option Analysis
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Option 1: Long term patency rates are more than 98%
Correct. The most significant advantage of using the LIMA for LAD bypass is its demonstrably superior long-term patency rate, often exceeding 98% at 10 years and beyond. This sustained function is critical for the long-term success of the bypass surgery and patient survival.
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Option 2: It is close to LAD
While the LIMA is anatomically situated near the LAD, proximity alone is not the main reason for its preference. Graft performance (patency) is the key deciding factor.
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Option 3: Atherosclerosis is never seen in this vessel
This statement is incorrect. Although the LIMA is relatively resistant to atherosclerosis compared to other arteries or veins used as grafts, it is not immune. Atherosclerotic changes can still occur, albeit less frequently.
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Option 4: It is very easy to harvest
Harvesting the LIMA involves specific surgical techniques. While surgeons become proficient, the ease of harvesting is secondary to the graft's functional outcome, particularly its long-term patency.
Conclusion
The superior long-term patency rate is the defining characteristic that makes the LIMA the conduit of choice for the LAD artery in CABG procedures, leading to better patient outcomes compared to other available grafts.
Important Questions from Chest & Lung Surgery
Which of the following are correct for herniation via foramen of Morgagni?
1. It occurs posteriorly in chest.
2. Transverse colon is the commonest content.
3. Defect is between sternal and costal attachments.
4. It is a type of congenital hernia.
Select the answer using the code given below.
A patient of road traffic accident presents to the emergency with increasing restlessness and difficulty in breathing. The respiratory rate is $26$ breaths/minute; there are distended neck veins; trachea is deviated to the right side with hyper-resonant note and absence of breath sounds on the left side. Which of the following statements are correct?
1. The most probable clinical diagno- sis is left tension pneumothorax
2. Immediate chest decompression using wide bore cannula in left second intercostal space should be done
3. Immediate chest X-ray should be done to confirm the clinical diagnosis
4. Definitive chest tube insertion in left fifth intercostal space should be done
Select the correct answer using the code given below :
- A patient of road traffic accident presents to the emergency with increasing restlessness and difficulty in breathing. The respiratory rate is 26 breaths/minute; there are distended neck veins; trachea is deviated to the right side with hyper-resonant note and absence of breath sounds on the left side. Which of the following statements are correct?
1. The most probable clinical diagno-sis is left tension pneumothorax
2. Immediate chest decompression using wide bore cannula in left second intercostal space should be done
3. Immediate chest X-ray should be done to confirm the clinical diagnosis
4. Definitive chest tube insertion in left fifth intercostal space should be done
Select the correct answer using the code given below : - A 50 year old male presented with pain along the left arm and ptosis. His chest X-ray showed soft tissue opacity at the apex of the left lung along with the erosion of the adjacent rib. The probable diagnosis is:
- Which of the following are the Indications for lung transplantation?
1. Emphysema
2. Primary pulmonary hypertension
3. Obliterative bronchiolitis
Select the correct answer using the code given below:
