Document Detail


Coronary artery bypass grafting after pneumonectomy.
MedLine Citation:
PMID:  19156245     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
When open-heart operations are necessary in patients who have undergone pneumonectomy, the unavoidable shift of mediastinal structures should be carefully considered. Surgical access, revascularization procedures, and the institution of cardiopulmonary bypass can all require approaches that differ from the usual. In particular, no general recommendations exist regarding the management of patients who undergo coronary artery bypass grafting after pneumonectomy. We successfully performed coronary artery bypass grafting in a 57-year-old man who had undergone a left pneumonectomy 7 years previously. Because the patient's heart was completely displaced into the left posterior hemithorax, access via a left posterolateral thoracotomy was chosen. Saphenous vein grafts were chosen over the internal mammary artery. The distal anastomoses were performed with use of the off-pump technique; for the proximal anastomosis, 2 venous grafts were implanted into the descending aorta. The patient's postoperative course was uneventful, and postoperative angiography revealed patent grafts. Herein, we discuss the case of this patient, and we present some considerations that can influence surgical approaches in similar circumstances.
Authors:
Bai-Qin Zhao; Ru-Kun Chen; Jian-Ping Song
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Texas Heart Institute journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital     Volume:  35     ISSN:  1526-6702     ISO Abbreviation:  Tex Heart Inst J     Publication Date:  2008  
Date Detail:
Created Date:  2009-01-21     Completed Date:  2009-08-19     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  8214622     Medline TA:  Tex Heart Inst J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  470-1     Citation Subset:  IM    
Affiliation:
Department of Thoracic & Cardiovascular Surgery, The Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310009, People's Republic of China. zhaobaiqin@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Angina, Unstable / etiology,  surgery*
Aorta, Thoracic
Coronary Artery Bypass / methods*
Coronary Artery Disease / complications,  surgery*
Humans
Male
Middle Aged
Pneumonectomy / adverse effects*
Respiratory Insufficiency / complications
Saphenous Vein / transplantation
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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