Coronary artery bypass grafting for patients with an atherosclerotic ascending aorta

2001 ◽  
Vol 49 (4) ◽  
pp. 195-200 ◽  
Author(s):  
Hitoshi Ogino ◽  
Yuichi Ueda ◽  
Takafumi Tahata ◽  
Takaaki Sugita ◽  
Junichiro Nishizawa ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Ascending Aorta ◽  
Bypass Grafting ◽  
Artery Bypass Grafting ◽  
Atherosclerotic Ascending Aorta

scholarly journals Distribution of Thoracic Aortic Calcifications in Patients Undergoing Coronary Artery Bypass Grafting

Aorta ◽  
2017 ◽  
Vol 05 (05) ◽  
pp. 132-138 ◽  
Author(s):  
Adem Diken ◽  
Adnan Yalçınkaya ◽  
Sertan Özyalçın
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Classification System ◽  
Artery Bypass ◽  
Ascending Aorta ◽  
Bypass Grafting ◽  
Artery Bypass Grafting ◽  
Artery Disease

Background: In procedures involving surgical maneuvers such as cannulation, clamping, or proximal anastomosis where aortic manipulation is inevitable, a preliminary assessment of atherosclerotic plaques bears clinical significance. In the present study, our aim was to evaluate the frequency and distribution of aortic calcifications in patients undergoing coronary artery bypass grafting (CABG) surgery to propose a morphological classification system. Methods: A total of 443 consecutive patients with coronary artery disease were included in this study. Preoperative non-contrast enhanced computed tomography images, in-hospital follow-up data, and patient characteristics were retrospectively evaluated. Results: Whereas 33% of patients had no calcifications at any site in the aorta, 7.9%, 75.4%, and 16.7% had calcifications in the ascending aorta, aortic arch, and descending aorta, respectively. Focal small calcifications were the most common type of lesions in the ascending aorta (3.9%), whereas 9 patients (1.4%) had porcelain ascending aorta. We defined four types of patients with increasing severity and extent of calcifications. Conclusions: Based on the frequency and distribution of calcifications in the thoracic aorta, we propose a classification system from least to most severe for coronary artery disease patients who are candidates for CABG.

scholarly journals The problem of calcified ascending aorta during aortocoronary bypass

2004 ◽  
Vol 61 (1) ◽  
pp. 15-20
Author(s):  
Dusko Nezic ◽  
Aleksandar Knezevic ◽  
Milan Cirkovic ◽  
Branko Petrovic ◽  
Miomir Jovic ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Extracorporeal Circulation ◽  
Artery Bypass ◽  
Ascending Aorta ◽  
Beating Heart ◽  
The Other ◽  
Bypass Grafting ◽  
Artery Bypass Grafting

Heavily calcified ascending aorta significantly increased morbidity and lethality during open-heart surgery. Cannulation and clamping (partial or total) of severely atherosclerotic ascending aorta can easily cause damage and rupture of aortic wall, with consequential distal (often fatal) embolization with atheromatous debris (brain, myocardium). From June 1998. until June 2000, 11 of 2 136 (0.5%) patients who underwent coronary artery bypass grafting were with the severe atheromatous ascending aorta. The site of cannulation was in the aortic arch in three patients (aorta was occluded with Foley catheter in one case, and single clamp technique was used in the other two cases). The femoral artery was the cannulation site in other five cases. Profound hypothermia, ventricular fibrillation, and circulatory arrest, with no cross-clamping or cardioplegia, were used in three patients. Two patients were operated on with extracorporeal circulation, one in normothermia, on the beating heart, the other in moderate hypothermia, on fibrillating heart. In three patients myocardial revascularization was performed on the beating heart, in normothermia, without extracorporeal circulation. Postoperative course was uneventful in all 11 patients. Neither atheroembolism in the peripheral organs, nor atheroembolism of the extramities occurred. The proposed surgical approaches have the potential to reduce the prevalence of stroke and systemic embolization associated with coronary artery bypass grafting in patients with heavily calcified ascending aorta. This result was achieved due to the applied modifications of standard cardiosurgical technique.

Intraoperative Dissection of Aorta and Successful Repair

1998 ◽  
Vol 6 (1) ◽  
pp. 66-67
Author(s):  
Nainar Madhu Sankar ◽  
Kevin Lai ◽  
Kenneth Harrison ◽  
Peter Klineberg ◽  
William Meldrum Hanna
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Transesophageal Echocardiography ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Ascending Aorta ◽  
Bypass Grafting ◽  
Artery Bypass Grafting ◽  
Intraoperative Transesophageal Echocardiography ◽  
Successful Repair

A 67-year-old female undergoing coronary artery bypass grafting developed dissection of the ascending aorta during decannulation. It was diagnosed by intraoperative transesophageal echocardiography and she underwent a successful repair.

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