Off-Pump Coronary Artery Bypass in a Patient with Congenital Absence of the Left Pericardium and an Extremely Left-Rotated Heart

2010 ◽  
Vol 13 (1) ◽  
pp. 63
Author(s):  
Andres Beiras-Fernandez ◽  
Sebastian Sadoni ◽  
Sebastian Michel ◽  
Felix Kur ◽  
Ferdinand Vogt ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Artery Bypass ◽  
Congenital Absence ◽  
Multivessel Coronary Artery Disease ◽  
Physical Relationship ◽  
Off Pump ◽  
Heart Insufficiency ◽  
Artery Disease ◽  
Computerized Tomographic Study ◽  
Pump Coronary Artery Bypass

Congenital anomalies of the pericardium are extremely rare and often difficult to diagnose. We describe a 66-year-old woman presenting with multivessel coronary artery disease and right heart insufficiency complicated by an extremely leftrotated heart due to a congenital absence of left pericardium. A multidetector row computerized tomographic study was performed to evaluate the torsion of the heart as well as the physical relationship between the left internal thoracic artery and the left coronary system. Off-pump coronary surgery was scheduled. Both the operative and postoperative courses were uneventful and the patient was discharged after 11 days.

scholarly journals One-Stop Hybrid Coronary Revascularization Versus Off-Pump Coronary Artery Bypass Grafting in Patients With Multivessel Coronary Artery Disease

2021 ◽  
Vol 8 ◽  
Author(s):  
Dongjie Li ◽  
Yulin Guo ◽  
Yingdi Gao ◽  
Xiangguang An ◽  
Yan Liu ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Revascularization ◽  
Artery Bypass ◽  
Multivessel Coronary Artery Disease ◽  
Off Pump ◽  
One Stop ◽  
Artery Disease ◽  
Pump Coronary Artery Bypass

Background: Data on one-stop hybrid coronary revascularization (HCR) are limited. This study aimed to compare the early and midterm outcomes of one-stop HCR with off-pump coronary artery bypass grafting (OPCAB) in patients with multivessel coronary artery disease.Methods: From April 2018 to May 2021, 752 patients with multivessel coronary artery disease who underwent isolated one-stop HCR or OPCAB were retrospectively included in this analysis. After exclusion and propensity score matching, 151 patients who underwent HCR were matched with 151 patients who underwent OPCAB. The primary endpoints were midterm major adverse cardiovascular and cerebrovascular events (MACCE) after the procedure. The secondary endpoints were in-hospital complications and outcomes.Results: The preprocedural characteristics were well balanced between the two groups after matching. The HCR group was associated with a lower rate of perioperative transfusion (23.8 vs. 53.0%, p < 0.001) and new-onset atrial fibrillation (AF) (5.3 vs. 15.2%, p = 0.004), shorter time of mechanical ventilation (h) [15 (16, 17) vs. 17 (16, 20), p < 0.001], and shorter length of stay (LOS) in the hospital (days) [19 (16, 24) vs. 22 (18, 27), p = 0.001]. Cumulated MACCE rates were similar between the two groups (15.9 vs. 14.0%, p = 0.59) during a median follow-up of 20 months.Conclusions: One-stop HCR is safe and efficacious with less invasiveness and faster postoperative recovery in selected patients with multivessel coronary artery disease. Randomized controlled trials with larger sample sizes and long-term follow-up are warranted to confirm these findings.

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