[Left innominate artery arising from the ascending aorta in the absence of right innominate artery]

It is important to detect anatomic variants of the supraaortic trunks prior to cardiovascular surgery in order to adjust the surgical technique. We report here, an anatomic variant that was not described previously, detected on a chest multidetector CT and confirmed during surgery. This variant consists of a left innominate artery, arising from the ascending aorta before the right subclavian and common carotid arteries that arise separately from the aortic arch. It is important to notice the absence of associated cardiovascular malformations. We formulate a possible explanation of the described variant through an embryologic study of the vasculogenesis.

[Segmental variations of great saphenous vein diameters in a coronary triple vessel disease population]

BACKGROUND

Great saphenous vein is one of the most used grafts in cardiovascular surgery. There is little amount of data in the medical literature describing dimensions of this vein. This series describes dimensions of the great saphenous vein in a coronary population and their variations.

PATIENTS AND METHODS

Retrospective series of patients admitted to the cardiovascular surgery department of Hotel-Dieu de France Hospital - Beirut, between January 2003 and June 2006 for elective coronary artery bypass grafting and having a preoperative Doppler ultrasound of the saphenous veins according to a standardized protocol. Great saphenous vein dimensions were analyzed with regard to patients' characteristics using multivariable analysis of variance.

RESULTS

Four hundred and two subjects were included with a mean age 64.4+/-9.3 years and a mean body mass index 27.9+/-4.5 kg/m(2). Women presented 22.6% of the series. Great saphenous vein dimensions' variations according to gender were significant (Multivariate Pillay trace=0.001) below the knee. Dimensions' variations were also significant as function of body mass index (P=0.001) and body surface (P=0.001). Age and cardiovascular risk factors did not influence GSV diameters.

CONCLUSION

This series allowed constructing reference tables of the great saphenous vein segmental diameters in patients admitted for coronary artery surgery. Female sex is associated with lower segmental diameters below the knee and body mass index and body surface are linearly associated with segmental diameters at all levels.