Mitral Valve Repair with Coronary Artery Bypass under Ventricular Fibrillation in a Case with an Atherosclerotic Ascending Aorta.
10.4326/jjcvs.31.233
- VernacularTitle:上行大動脈高度動脈硬化症例に対する心室細動下僧帽弁形成術ならびに冠動脈バイパス術
- Author:
Masaru Yoshikai
;
Masakatsu Hamada
;
Junichi Murayama
;
Keishi Kamohara
;
Yasushi Hisamatsu
- Publication Type:Journal Article
- From:Japanese Journal of Cardiovascular Surgery
2002;31(3):233-235
- CountryJapan
- Language:Japanese
-
Abstract:
A 76-year-old man was admitted with a diagnosis of mitral valve regurgitation and angina pectoris. Cardiac catheterization demonstrated grade III mitral valve regurgitation with elevated pulmonary pressure and stenosis in the LAD. Severe stenosis in the left internal carotid artery and multiple cerebral infarctions were also recognized. Mitral valve repair with coronary artery bypass was performed at one month after the left carotid endarterectomy. The ascending aorta contained fragile atheroma, so an arterial cannula was inserted into the graft anastomosed to the right axillary artery. Mitral valve repair with coronary artery bypass was performed under moderately hypothermic ventricular fibrillation. Air embolism in the right coronary artery was recognized during systemic rewarming. Mitral valve repair with coronary artery bypass was performed safely under moderately hypothermic ventricular fibrillation in this case of an atherosclerotic ascending aorta. Axillary artery cannulation is useful to avoid cerebral complications in such cases. The de-airing procedure should be completed before the initiation of the heart beating.
