Redo Off-Pump Coronary Artery Bypass Grafting through Left Thoractomy Using the Aortic Connector for Proximal Graft Anastomosis on the Descending Aorta

概要

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A 76-year-old man who had undergone primary coronary operation through a median sternotomy 9 years previously presented with recurrent angina. Preoperative angiography revealed 90% stenosis of the circumflex coronary artery and left subclavian artery. Two saphenous vein grafts (SVG) placed in the previous operation were patent. Redo off-pump CABG was performed through a left thoracotomy approach. The proximal end of the new SVG was connected to the descending thoracic aorta using the St. Jude Medical aortic connector system. The distal anastomosis to the obtuse marginal branch was performed on a beating heart. The postoperative course was uneventful. This case suggested that, in cases requiring the proximal graft anastomosis on the descending aorta, the application of the aortic connector system can be a useful strategy, helping to facilitate the proximal anastomosis and avoid complications associated with the aortic partial-clamping on the descending aorta.
特定非営利活動法人日本心臓血管外科学会の論文