A Case of Off-Pump Coronary Artery Bypass for Acute Myocardial Infarction with Cardiogenic Shock.
10.4326/jjcvs.29.339
- VernacularTitle:心原性ショックを呈した急性心筋梗塞に対するｏｆｆ‐ｐｕｍｐ冠状動脈バイパス術の１治験例
- Author:
Takashi Ueda
;
Tetsuji Kawata
;
Hiroshi Naito
;
Michitaka Kimura
;
Shigeki Taniguchi
- Publication Type:Journal Article
- Keywords:
OPCAB
- From:Japanese Journal of Cardiovascular Surgery
2000;29(5):339-342
- CountryJapan
- Language:Japanese
-
Abstract:
A 67-year-old man was considered a candidtate for CABG because coronary angiogram showed obstruction segment 6 and stenoses of segments 9 and 12. He underwent emergency CABG due to acute myocardial infarction (AMI) with cardiogenic shock caused by hemorrhage from a gastric ulcer. Because of hypoxia due to pulmonary edema and acute renal failure an intraaortic baloon was inserted. He had a history of cerebrovascular stroke. Although coronary angiogram revealed multiple vessel disease, we performed off-pump coronary artery bypass (saphenous vein graft-left anterior descending artery) for salvage, because cardiopulmonary bypass was considered very risky and further systemic heparinization might be fatal. He has returned to his job, and is now free from angina. As AMI with cardiogenic shock is often caused by a lesion in the LAD, CABG without cardiopulmonary bypass may be an effective technique in certain selected patients.
