[Coronary artery bypass grafting surgery without cardiopulmonary bypass in a patient with calcified aorta]
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H Noda1, Y Tanimoto, K Yoshimura
1Department of Cardiology, Ehime Rohsai Hospital, Niihama, Japan.
Insights
Off-pump coronary artery bypass surgery using the left internal thoracic artery graft is a safe option for patients with severe calcified aorta, avoiding complications from cardiopulmonary bypass.
Area of Science:
- Cardiovascular Surgery
- Minimally Invasive Cardiac Procedures
Background:
- Severe calcification of the ascending aorta poses significant risks during traditional coronary artery bypass grafting (CABG) due to aortic cross-clamping and cannulation.
- Conventional CABG often necessitates cardiopulmonary bypass (CPB), which carries its own set of potential complications.
Observation:
- A 67-year-old male with severe calcified ascending aorta underwent coronary artery bypass surgery.
- The procedure was successfully performed without cardiopulmonary bypass, maintaining a beating heart.
- The left internal thoracic artery was utilized as the graft.
Findings:
- The patient experienced no neurological complications post-surgery.
- Postoperative angiography confirmed excellent patency of the left internal thoracic artery graft.
- The off-pump technique demonstrated feasibility and safety in this high-risk patient.
Implications:
- Coronary revascularization without cardiopulmonary bypass presents a safe and reliable alternative for patients with severely calcified aortas.
- This approach effectively mitigates risks associated with aortic manipulation and CPB.
- Off-pump CABG may be considered a valuable strategy to improve outcomes in selected patients with complex aortic pathology.
Abstract:
Coronary artery bypass surgery in a 67-year-old male with severe calcified ascending aorta was performed without cardiopulmonary bypass under beating heart, utilizing the left internal thoracic artery graft. No neurological complication was observed and postoperative angiogram showed good graft patency. We think coronary revascularization without cardiopulmonary bypass can be one of the safe and reliable methods to avoid complications associated with aortic cross clamping and aortic cannulation with severely calcified aorta.