An evaluation of coronary artery bypass grafting without aortic cross-clamping due to severely atherosclerotic ascending aorta

The Japanese Journal of Thoracic and Cardiovascular Surgery : Official Publication of the Japanese Association for Thoracic Surgery = Nihon Kyōbu Geka Gakkai Zasshi
Hideyuki FumotoYoshio Arai

Abstract

We evaluated coronary artery bypass grafting (CABG) in which aortic cross-clamping is not done due to severe atherosclerosis of the ascending aorta. Subjects were 51 patients undergoing CABG without aortic cross-clamping during cardiopulmonary bypass under moderately hypothermic ventricular fibrillation in the 12 years from June 1988 to October 1999 (Group N). In some cases, empty beating or moderate hypothermic circulatory arrest was used. We compared these 51 with 1104 subjects undergoing conventional CABG with aortic cross-clamping and cardioplegic cardiac arrest in the 9 years from June 1988 to December 1997 (Group A). In all 6 cases with neurologic deficits, moderately hypothermic circulatory arrest was used during proximal anastomosis of saphenous vein grafts. Postoperative computed tomography scan showed them to have suffered infarction due to embolization. Multivariate analysis identified proximal saphenous vein grafting under moderately hypothermic circulatory arrest as a predictor of neurologic deficit. Complete revascularization was significantly lower in Group N. Actual survival and freedom from cardiac death were significantly lower in Group N. Manipulation of the atherosclerotic ascending aorta under moderately hy...Continue Reading

References

Oct 1, 1990·The Annals of Thoracic Surgery·H OhtekiH Suda
Sep 1, 1989·The Annals of Thoracic Surgery·W G MarshallJ Saffitz
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Citations

Jun 11, 2010·Journal of Forensic Sciences·Ewout H MeijerHarald L G J Merckelbach

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