Coronary Bypass Surgery in Patient with Malaria

2002 ◽  
Vol 10 (2) ◽  
pp. 160-161 ◽  
Author(s):  
Mehmet Balkanay ◽  
Denyan Mansuroğlu ◽  
Kaan Kirali ◽  
Suat Nail Ömeroğlu ◽  
Cevat Yakut
Keyword(s):  
Bypass Surgery ◽  
Internal Mammary Artery ◽  
Left Internal Mammary Artery ◽  
Artery Bypass ◽  
Coronary Bypass ◽  
Early Postoperative Period ◽  
Beating Heart ◽  
Bypass Grafting ◽  
Antimalarial Therapy ◽  
Internal Mammary

A 65-year-old man with unstable angina pectoris developed malaria prior to coronary artery bypass grafting. After 3 weeks on antimalarial therapy, left internal mammary artery-toleft anterior descending artery anastomosis was performed on the beating heart to avoid the effects of cardiopulmonary bypass. There was no complication in the early postoperative period.

Nonrobotic Total Endoscopic Coronary Artery Bypass Grafting

2018 ◽  
Vol 13 (5) ◽  
pp. 344-348 ◽  
Author(s):  
Hagen Gorki ◽  
Jun Liu ◽  
Marius Sabau ◽  
Guenther Albrecht ◽  
Andreas Liebold
Keyword(s):  
Coronary Artery ◽  
Internal Mammary Artery ◽  
Left Internal Mammary Artery ◽  
Artery Bypass ◽  
Coronary Bypass ◽  
Minimal Invasive ◽  
Bypass Grafting ◽  
Coronary Bypass Grafting ◽  
Left Anterior Descending Artery ◽  
Internal Mammary

Objective At present, minimal invasive direct coronary artery grafting is the least invasive nonrobotic surgical approach to revascularize the left anterior descending artery with the left internal mammary artery. Total endoscopic coronary bypass grafting is performed with the help of a telemanipulator (“robot”). A prospective proof-of-concept study was initiated to investigate a nonrobotic total endoscopic coronary bypass grafting approach. Methods Twenty patients with significant left anterior descending artery or left main stem lesion were operated on via three or four left thoracic access ports. Under exclusive endoscopic vision, the left internal mammary artery was harvested and anastomosed to the left anterior descending artery manually. Cardiopulmonary bypass and cardioplegic arrest were planned in all cases. Results In 10 patients, the operation was completed successfully as nonrobotic total endoscopic coronary bypass grafting. Reasons for conversions to minimal invasive direct coronary artery grafting or conventional sternotomy were dense pleural adhesions (3 patients), bleeding of the anastomosis (3), diffuse bleeding during left internal mammary artery harvesting (2), identification problems of the target artery (1), or left internal mammary artery failure (1). Postoperative angiography in five primarily successful nonrobotic total endoscopic coronary bypass grafting patients showed patent anastomoses in four cases. One patient was reoperated on for early anastomotic failure in a 1.0-mm target vessel. Until now, a percutaneous coronary intervention of remaining lesions as staged hybrid procedure was performed in three patients (2 nonrobotic total endoscopic coronary bypass grafting, 1 minimal invasive direct coronary artery grafting). Conclusions With a thoroughly surveyed learning curve, nonrobotic total endoscopic coronary bypass grafting procedure could become an alternative to other available treatment options; however, the value of the procedure has to be further investigated.

scholarly journals On pump harvesting of Left Internal Mammary Artery (LIMA) in unstable patients undergoing coronary artery bypass grafting (CABG) is a safe operative strategy: A pilot study

2019 ◽  
Vol 35 (3) ◽  
Author(s):  
Muhammad Sher-i-Murtaza ◽  
Mirza Ahmad Raza Baig
Keyword(s):  
Cardiopulmonary Bypass ◽  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Internal Mammary Artery ◽  
Left Internal Mammary Artery ◽  
Artery Bypass ◽  
Hemodynamic Instability ◽  
Bypass Grafting ◽  
Operative Strategy ◽  
Internal Mammary

Objective: To evaluate the clinical safety of left internal mammary artery (LIMA) harvesting in hemodynamically unstable patients after establishing cardiopulmonary bypass (CPB) in isolated coronary artery bypass graft (CABG) surgery. Methods: The prospective observational study was conducted at Chaudhry Pervaiz Elahi Institute of Cardiology, Multan, Pakistan, from December 2016 to August 2018. All patients undergoing isolated CABG surgery in which LIMA conduit was harvested after establishing cardiopulmonary bypass because of hemodynamic instability at induction of anaesthesia or during surgery were included in the study. Preoperative, operative and postoperative characteristics of the patients were recorded. Data was analyzed using SPSS 19. Results: In Forty nine patients including 39 male and 10 female, early CPB had to be established because of hemodynamic instability and afterwards LIMA was harvested. Out of 49, 30 patients presented with CCS class III angina. 37 (75.5%) patients were scheduled on elective coronary surgery waiting list. There were 39 (79.59%) patients who weaned off bypass on mild inotropic support and 4 (8.16%) patients needed IABP support. All patients had multi-vessel coronary artery disease. Mean number of grafts were 3.428±0.577, CPB time was 110.59±25.594 and hospital stay was 5.367±1.424. Conclusions: The study showed that LIMA can be safely harvested in unstable patients after establishing extracorporeal circulation and by using this operative strategy in patients who need urgent or emergent surgical coronary revascularization LIMA can be safely used as a conduit. doi: https://doi.org/10.12669/pjms.35.3.988 How to cite this:Sher-i-Murtaza M, Baig MAR. On pump harvesting of Left Internal Mammary Artery (LIMA) in unstable patients undergoing coronary artery bypass grafting (CABG) is a safe operative strategy: A pilot study. Pak J Med Sci. 2019;35(3):---------.  doi: https://doi.org/10.12669/pjms.35.3.988 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Robotic Totally Endoscopic Multivessel Coronary Artery Bypass Grafting Procedure Development, Challenges, Results

2012 ◽  
Vol 7 (1) ◽  
pp. 3-8 ◽  
Author(s):  
Johannes Bonatti ◽  
Jeffrey D. Lee ◽  
Nikolaos Bonaros ◽  
Thomas Schachner ◽  
Eric J. Lehr
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Bypass Surgery ◽  
Artery Bypass ◽  
Beating Heart ◽  
Bypass Grafting ◽  
Artery Bypass Grafting ◽  
Conversion Rates ◽  
Internal Mammary

Closed-chest totally endoscopic coronary artery bypass grafting (TECAB) is feasible using robotic technology. During the early phases, TECAB was restricted to single bypass grafts to the left anterior descending artery system. Because most patients referred for coronary artery bypass surgery have multivessel disease, development of endoscopic multiple bypass grafting is mandatory. Experimental work on multivessel TECAB was carried out in the early 2000s, and first clinical cases were already performed. With further technological development of operating robots, double, triple, and quadruple TECAB has become feasible both on the arrested heart and on the beating heart. To date, 161 cases of multivessel TECAB using the da Vinci telemanipulation systems are published in the literature. The main advances enabling multivessel TECAB were the availability of a robotic endostabilizer for beating heart procedures and increased surgeon skills using remote access heart-lung machine perfusion and endo-cardioplegia. Both internal mammary arteries can be harvested and both radial artery and vein graft can be used in multivessel TECAB. Y-grafting and sequential grafting are feasible. Multivessel endoscopic surgical revascularization can be combined with percutaneous coronary interventions in advanced hybrid coronary revascularization. Time requirements for multivessel TECAB are significant, and conversion rates to larger thoracic incisions are higher than those observed for single-vessel TECAB. Clinical short- and long-term outcomes, however, seem to meet the standards of open coronary bypass surgery through sternotomy. The main advantages of multivessel TECAB are a completely preserved sternum, use of double internal mammary artery even in risk groups, and a remarkably short recovery time.

Maximal utilization of the left internal mammary artery for coronary bypass grafting

1996 ◽  
Vol 61 (6) ◽  
pp. 1848-1849 ◽  
Author(s):  
Lawrence I. Bonchek ◽  
Mark W. Burlingame ◽  
Brad E. Vazales ◽  
Edward F. Lundy
Keyword(s):  
Internal Mammary Artery ◽  
Left Internal Mammary Artery ◽  
Coronary Bypass ◽  
Bypass Grafting ◽  
Coronary Bypass Grafting ◽  
Internal Mammary

scholarly journals Early Patency Evaluation of New Distal Anastomotic Device in Internal Mammary Artery Grafts Using Computed Tomography Angiography

2010 ◽  
Vol 5 (2) ◽  
pp. 109-113 ◽  
Author(s):  
Husam H. Balkhy ◽  
L. Samuel Wann ◽  
Susan Arnsdorf
Keyword(s):  
Computed Tomography ◽  
Coronary Artery ◽  
Multidetector Computed Tomography ◽  
Coronary Artery Bypass ◽  
Bypass Surgery ◽  
Internal Mammary Artery ◽  
Artery Bypass ◽  
Coronary Bypass ◽  
Graft Patency ◽  
Internal Mammary

Introduction Traditional coronary artery bypass grafting is performed using a hand sewn technique. The C-Port xA and Flex A anastomotic stapling devices (Cardica Inc., Redwood City, CA) were cleared by the Food and Drug Administration for use in distal coronary anastomoses in November 2006 and April 2007, respectively. They provide the ability to create a compliant, consistently reproducible, and automated anastomosis. Multidetector computed tomography (CT) has been shown to be effective in evaluating coronary artery bypass graft patency. Methods The first 24 patients to undergo internal mammary artery (IMA) anastomosis using the automated device in our practice were included in the study. Twenty-five IMA grafts (24 left IMA and 1 right IMA) were created using the C-Port xA or Flex A anastomotic device as part of multivessel off-pump coronary revascularization by sternotomy. Graft patency was evaluated at 30 days in the first 10 grafts and at 90 days in the next 15 grafts using multidetector (64 slice) CT. Results There were no device failures. There were no perioperative strokes, myocardial infarctions, or deaths. All 10 IMA grafts evaluated at 30 days were patent using multidetector CT. One of the 15 IMA grafts studied at 90 days was occluded using multidetector computed tomography. Conclusions The C-Port xA and Flex A distal anastomotic devices provided a safe and effective means to create a left IMA-left anterior descending artery anastomoses in coronary bypass surgery with excellent short to midterm patency in this early experience. Long-term follow-up is warranted. These findings will have important implications for future sternal sparing coronary bypass surgery.

Beating Heart Aortic Valve Replacement After Previous Coronary Artery Bypass Surgery With a Patent Internal Mammary Artery Graft

2007 ◽  
Vol 83 (3) ◽  
pp. 1206-1209 ◽  
Author(s):  
Roberto Battellini ◽  
Ardawan Julian Rastan ◽  
Alexander Fabricius ◽  
Martin Moscoso-Luduena ◽  
Nicole Lachmann ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Aortic Valve ◽  
Coronary Artery Bypass Surgery ◽  
Bypass Surgery ◽  
Internal Mammary Artery ◽  
Artery Bypass ◽  
Beating Heart ◽  
Artery Graft ◽  
Internal Mammary Artery Graft ◽  
Internal Mammary
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