Total aortic arch replacement for a patient with poor left ventricular function and patent coronary artery bypass grafts: how to establish effective myocardial protection
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Kosaku Nishigawa, MD · Hiroshi Kubo, MD Yasuhiro Yunoki, MD · Atsushi Tabuchi, MD Hisao Masaki, MD · Kazuo Tanemoto, MD
- چاپ و سال / کشور: 2011
Description
A 66-year-old man who had previously undergone coronary artery bypass grafting (CABG) was admitted to our institution for surgical treatment of a ruptured aortic arch aneurysm. He had three patent bypassed grafts including the left internal thoracic artery (LITA) to the left anterior descending artery (LAD), complicated by left ventricular dysfunction. Coronary angiography performed 1 year after the initial surgery revealed total occlusion of the LAD. In addition, the aneurysm was located next to the LITA; therefore, there was a signifi cant risk of injury to the LITA during intraoperative dissection. For such a complicated and challenging case, we successfully performed a total aortic arch replacement using a Y-shaped composite saphenous vein graft (SVG) for the administration of cardioplegic solution to establish effective myocardial protection. This procedure, by which effective myocardial protection can be achieved, is a useful treatment option for aortic arch surgery after CABG with a patent LITA graft.
Gen Thorac Cardiovasc Surg (2011) 59:518–521 DOI 10.1007/s11748-010-0720-x Received: 22 July 2010 / Accepted: 26 September 2010
