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Updated: Jul 17, 2026
Surgical Swine Model of Chronic Cardiac Ischemia Treated by Off-Pump Coronary Artery Bypass Graft Surgery
Published on: March 27, 2018
Blind surgical coronary revascularization
Christine Herman1, Simon Jackson, Jeremy Wood
1Division of Cardiac Surgery, Halifax, Nova Scotia, Canada. cherman@dal.ca
Insights
Severe peripheral vascular disease prevented standard angiography in a patient with unstable coronary artery disease. Coronary artery bypass grafting was successfully performed without preoperative imaging, leading to a full recovery.
Area of Science:
- Cardiology
- Vascular Surgery
Background:
- Unstable coronary artery disease necessitates timely intervention.
- Severe peripheral vascular disease can preclude standard diagnostic angiography.
Observation:
- A 53-year-old woman with unstable coronary artery disease had no suitable access for coronary angiography due to severe peripheral vascular disease.
- Medical management failed, evidenced by persistent angina, ECG changes, hemodynamic instability, and reinfarction markers.
Findings:
- Coronary artery bypass grafting was performed without preoperative coronary angiography.
- All major coronary territories were successfully grafted.
Implications:
- Coronary artery bypass grafting is a viable option for revascularization in patients with complex coronary and peripheral vascular disease when angiography is not feasible.
- This approach can lead to successful outcomes and symptom relief in select high-risk patients.
Abstract:
A 53-year-old woman presented with unstable coronary artery disease and severe peripheral vascular disease that prevented brachial, axillary, and femoral access for coronary angiography. Intensive medical management failed with ongoing angina, dynamic ECG changes, hemodynamic instability, and biochemical evidence of reinfarction. Coronary artery bypass grafting was performed without preoperative angiography. Each major coronary territory was grafted. The patient recovered postoperatively without angina at 1-year follow-up.
