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New Proximal Anastomosis Technique for Calcified Ascending Aorta in Coronary Artery Bypass Grafting
Chuan Wang1, Wei-Guo Ma1, Yang Yu1
1Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
Insights
This study presents a novel clampless technique for coronary artery bypass grafting in patients with calcified aorta. The Foley catheter method offers a safe and effective alternative for proximal anastomosis, achieving excellent graft patency.
Area of Science:
- Cardiovascular Surgery
- Surgical Innovation
Background:
- Coronary artery bypass grafting (CABG) often faces challenges with calcified ascending aortas.
- Standard techniques for proximal anastomosis can be difficult and risky in these cases.
Purpose of the Study:
- To describe and evaluate an alternative clampless technique for proximal anastomosis in CABG.
- To assess the safety and efficacy of using a Foley catheter and polypropylene suture for calcified ascending aortas.
Main Methods:
- A novel technique utilizing a Foley catheter and polypropylene suture was employed for clampless proximal anastomosis.
- The procedure was performed on 30 patients undergoing coronary artery bypass grafting.
Main Results:
- The mean time for proximal anastomosis was 18.9 ± 1.3 minutes.
- No early or late deaths were observed; stroke occurred in 2 high-risk patients.
- At a mean follow-up of 1.6 years, graft patency was 93% with only 1 patient experiencing recurrent angina.
Conclusions:
- This alternative clampless technique is a safe and effective approach for managing calcified ascending aortas during CABG.
- The method demonstrates favorable outcomes, including high graft patency and low complication rates.
Abstract:
To deal with calcified ascending aorta during coronary artery bypass grafting, we describe an alternative technique to create a clampless proximal anastomosis using a Foley catheter and polypropylene suture. In 30 patients, the number of distal anastomoses averaged 3.1 ± 0.7, and mean time of proximal anastomosis was 18.9 ± 1.3 minutes. Neither early nor late death occurred. Stroke occurred in 2 high-risk patients. At mean 1.6 ± 0.5 years of follow-up, 1 patient sustained recurrent angina, and graft patency was 93%. These favorable outcomes show that this alternative technique is a safe and effective approach to calcified ascending aorta in coronary artery bypass grafting.
