Document Detail


Active distal coronary perfusion to prevent regional myocardial ischemia in off-pump coronary artery bypass grafting.
MedLine Citation:
PMID:  15312019     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Regional myocardial ischemia during anastomosis in off-pump coronary artery bypass (OPCAB) can occasionally cause hemodynamic instability. To prevent regional myocardial ischemia and stabilize the hemodynamics during the procedure, perfusion of the distal coronary artery to the anastomotic site is necessary as the only reliable method. We have applied an active coronary perfusion method using a servo-controlled pump in selected patients in place of conventional passive perfusion methods (intraluminal shunt and external shunt). We present a case in which the active perfusion method proved useful in avoiding regional myocardial ischemia. A 74-year-old male patient with triple-vessel coronary disease underwent OPCAB for unstable angina. During revascularization of the main right coronary artery, the hemodynamics collapsed due to regional myocardial ischemia. As soon as the distal coronary artery was perfused at a high flow rate around 80 ml/min, the hemodynamics stabilized and the operation was completed successfully. This active coronary perfusion method in OPCAB is particularly useful in cases in which regional myocardial ischemia cause hemodynamic instability.
Authors:
Hankei Shin; Kiyoshi Koizumi; Toru Matayoshi; Ryohei Yozu
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia     Volume:  10     ISSN:  1341-1098     ISO Abbreviation:  Ann Thorac Cardiovasc Surg     Publication Date:  2004 Jun 
Date Detail:
Created Date:  2004-08-17     Completed Date:  2004-09-21     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9703158     Medline TA:  Ann Thorac Cardiovasc Surg     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  198-201     Citation Subset:  IM    
Affiliation:
Division of Cardiovascular Surgery, Department of Surgery, Keio University School of Medicine, Tokyo, Japan.
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MeSH Terms
Descriptor/Qualifier:
Aged
Anastomosis, Surgical
Coronary Artery Bypass*
Humans
Male
Myocardial Ischemia / etiology,  prevention & control*
Perfusion / instrumentation*

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