1.Coronary Artery Bypass Grafting in the Presence of Atherosclerotic Lesions in the Ascending Aorta.
Tadashi Isomura ; Toru Satoh ; Nobuhiko Hayashida ; Hiroshi Maruyama ; Kouichi Hisatomi ; Tatsuya Higashi ; Kouichi Arinaga ; Ikutaroh Akasu ; Kenichi Kosuga ; Shigeaki Aoyagi
Japanese Journal of Cardiovascular Surgery 1997;26(2):77-82
The results and surgical techniques were studied in 59 patients who had atherosclerotic lesions in the ascending aorta. Arterial grafting (AG) and sequential grafting for coronary artery bypass grafting (CABG) was used in as many as possible cases and the number of distal anastomoses with AG was 1.3/patient (internal thoracic artery (ITA), 56 anastomoses for 50 patients; gastroepiploic artery (GEA), 17; and inferior epigastric artery, 3). Calcification in the ascending aorta was noted in 26 patients and arterial cannulation was performed via the right axillary artery in 4 patients. Saphenous vein grafts were used for 51 patients and 30 of them required aortic reconstruction for proximal anastomosis. There were 2 hospital deaths (non-cardiac) and no neurological complications. It is difficult to perform CABG in the presence of atherosclerosis in the ascending aorta. However, the right axillary artery cannulation as the site of arterial cannulation and the use of sequential grafting, using ITA and GEA as the pedicled arterial conduits are useful to accomplish CABG in such patients. Neurological complication seems to be manufactured at a minimal level by cautious operative techniques.
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