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[Successful aorto-circumflex coronary bypass grafting through left thoracotomy following aortic and mitral valve
1Department of Thoracic & Cardiovascular Surgery, Yokohama Sakae Kyosai Hospital, Japan.
Insights
This study details a successful descending thoracic aorto-circumflex coronary artery bypass graft using a saphenous vein graft in a female patient. The minimally invasive procedure provided a smooth recovery and normal life for the patient post-discharge.
Area of Science:
- Cardiovascular Surgery
- Interventional Cardiology
- Vascular Grafting
Background:
- Severe angina post-aortic and mitral valve replacement necessitates alternative revascularization strategies.
- Significant (99%) stenosis of the circumflex coronary artery identified via coronary angiography.
Observation:
- A 44-year-old female patient presented with post-valve replacement angina.
- Successful surgical intervention involved descending thoracic aorto-circumflex coronary artery bypass grafting.
Findings:
- The procedure utilized a saphenous vein graft via a left thoracotomy approach.
- Partial cardiopulmonary bypass and hypothermia (22°C) were employed during the surgery.
- Minimal intraoperative and postoperative bleeding was observed.
Implications:
- This technique offers a viable option for complex coronary artery bypass grafting in specific patient populations.
- The successful outcome suggests potential for improved patient recovery and quality of life.
- Minimally invasive approaches in cardiac surgery may reduce complications and hospital stays.
Abstract:
We report successful descending thoracic aorto-circumflex coronary artery bypass grafting using a saphenous vein graft through left thoracotomy in a 44-year-old female. The patient developed severe angina attack after aortic and mitral valve replacement. Coronary angiography showed 99% stenosis of the circumflex coronary artery. Under general anesthesia, left femoral vein to arterial partial cardiopulmonary bypass was performed via left 4 th intercostal space. Body temperature was lowered to 22 degrees centigrade, and spontaneous cardiac fibrillation occurred. After minimal exposure by pericardial dissection of the circumflex coronary artery, distal anastomosis and then proximal anastomosis at the descending thoracic aorta was carried out under cardiac fibrillation. This surgery was done with minimal intra-and postoperative bleeding. Postoperative course was very smooth, and the patient was discharged and leading a normal life for 6 months after surgery.