Salvage of left Cabrol limb occlusion by minimally invasive direct coronary bypass grafting

Area of Science:

• Cardiovascular Surgery
• Cardiac Surgery
• Aortic Surgery

Background:

• Aortic root reconstruction using Cabrol or modified Cabrol techniques can be associated with complications.
• Coronary artery complications, such as graft limb occlusion, may occur post-operatively.

Purpose of the Study:

• To report two cases of acute myocardial infarction (AMI) secondary to left coronary graft limb occlusion after aortic root reconstruction.
• To highlight the successful management of this complication using emergency minimally invasive direct coronary artery bypass grafting (MIDCAB).

Main Methods:

• Two patients underwent aortic root reconstruction (Cabrol or modified Cabrol technique) for aortic pathologies.
• Both patients developed acute myocardial infarction (AMI) post-operatively.
• Diagnosis of left coronary graft limb occlusion was confirmed via imaging (CT, coronary arteriography).

Main Results:

• Acute myocardial infarction (AMI) occurred 3 and 7 months post-surgery in the two patients.
• Occlusion of the left coronary perfusion graft limb was identified as the cause.
• Both patients were successfully treated with emergency minimally invasive direct coronary artery bypass grafting (MIDCAB).

Conclusions:

• Left coronary graft limb occlusion is a potential complication following Cabrol or modified Cabrol aortic root reconstruction.
• Emergency minimally invasive direct coronary artery bypass grafting (MIDCAB) is an effective treatment for acute myocardial infarction caused by graft limb occlusion.