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Updated: Aug 23, 2026

Surgical Porcine Model of Chronic Myocardial Ischemia Treated by Exosome-laden Collagen Patch and Off-pump Coronary Artery Bypass Graft
05:25

Surgical Porcine Model of Chronic Myocardial Ischemia Treated by Exosome-laden Collagen Patch and Off-pump Coronary Artery Bypass Graft

Published on: September 15, 2023

[Cholesterol crystal embolization exacerbated after the off-pump coronary artery bypass; report of a case]

T Iwakura1, S Enomoto, K Yamamoto

  • 1Department of Cardiovascular Surgery, Okamura Memorial Hospital, Shizuoka, Japan.

Kyobu Geka. the Japanese Journal of Thoracic Surgery
|June 19, 2004
PubMed

Insights

Cholesterol embolism is a rare complication following cardiovascular procedures like off-pump coronary artery bypass (OPCAB). Early diagnosis via skin biopsy and prompt steroid therapy can improve patient survival.

Area of Science:

  • Cardiovascular Surgery
  • Nephrology
  • Dermatology

Background:

  • Left main trunk disease necessitates interventions such as off-pump coronary artery bypass (OPCAB).
  • Coronary angiography and cardiovascular surgery are potential triggers for cholesterol embolism.
  • Cholesterol embolism syndrome presents a diagnostic and therapeutic challenge.

Observation:

  • A 66-year-old male patient developed acute renal failure and purpura on his feet 1 month post-OPCAB.
  • Clinical presentation included characteristic skin lesions at the toe tips.
  • The patient had undergone coronary angiography and OPCAB for left main trunk disease.

Findings:

  • The patient's condition was diagnosed as cholesterol embolism.
  • Renal function deterioration and skin manifestations were key indicators.
  • Skin biopsy confirmed the presence of cholesterol crystals in small arteries.

Implications:

  • Steroid therapy, though not universally optimal, contributed to patient survival in this case.
  • Early diagnosis through vigilant observation and skin biopsy is crucial for managing cholesterol embolism.
  • This case highlights the importance of considering cholesterol embolism in patients with relevant procedural history and subsequent multi-organ dysfunction.

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