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Updated: Jun 21, 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

Management of multiple sequential complications following coronary artery bypass grafting: a case report from

Husein Mufaddal Hassanali1, Nikhil Bhat2, Mufaddal A Lunawadawala3

  • 1Department of Cardiovascular Surgery, Saifee hospital, Dar es salaam, Tanzania.

Journal of Cardiothoracic Surgery
|June 19, 2026
PubMed

Insights

This case study details a complex recovery after coronary artery bypass grafting (CABG) surgery. It highlights the successful management of multiple, severe postoperative complications through multidisciplinary care and rehabilitation.

Area of Science:

  • Cardiovascular Surgery
  • Thoracic Surgery
  • Critical Care Medicine

Background:

  • Coronary artery bypass grafting (CABG) is a standard treatment for advanced coronary artery disease (CAD).
  • Patients with multiple comorbidities undergoing CABG face significant risks of life-threatening postoperative complications.
  • This case involves a 63-year-old male with triple-vessel CAD and several comorbidities (diabetes, hypertension, obesity, asthma).

Purpose of the Study:

  • To illustrate the challenges of managing sequential, severe postoperative complications following CABG.
  • To emphasize the critical role of early recognition and multidisciplinary intervention in patient outcomes.
  • To highlight the importance of structured rehabilitation in restoring functional capacity after complex surgical recovery.

Main Methods:

  • On-pump CABG using bilateral internal mammary artery grafts.
  • Emergency re-exploration and modified Robicsek sternal closure for traumatic sternal wound dehiscence.
  • Management of critical illness polyneuropathy and myopathy overlap syndrome (CIPNM) with supportive care and rehabilitation.
  • Treatment of deep sternal wound infection (Pseudomonas aeruginosa) including antibiotics, debridement, negative pressure wound therapy, and flap reconstruction.
  • Management of associated complications: arrhythmia, airway issues, acute kidney injury, pleural effusion, and electrolyte disturbances.

Main Results:

  • Successful management of traumatic sternal wound dehiscence and deep sternal wound infection.
  • Recovery from critical illness polyneuropathy and myopathy overlap syndrome (CIPNM).
  • Resolution of multiple associated complications including arrhythmia, acute kidney injury, and pleural effusion.
  • Complete wound healing and restoration of functional capacity after eight months of coordinated care.

Conclusions:

  • Sequential postoperative complications after CABG can be complex and severe.
  • Early recognition and prompt, multidisciplinary intervention are crucial for managing these complications.
  • Structured rehabilitation plays a vital role in achieving favorable long-term outcomes and functional recovery.
Abstract

Keywords:
Coronary artery bypass graftingCritical illness neuromyopathyDeep sternal wound infectionNegative-pressure wound therapySternal dehiscenceTanzania

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