eISSN: 1897-4252
ISSN: 1731-5530
Kardiochirurgia i Torakochirurgia Polska/Polish Journal of Thoracic and Cardiovascular Surgery
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1/2008
vol. 5
 
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Extensive LAD endarterectomy with beating heart, vein patch reconstruction of LAD in an 85-year-old patient via MIDCAB approach

Maciej Rachwalik
,
Neil Roberts
,
Josephine Anna Wright
,
Vaja Chandrasekeran

Kardiochirurgia i Torakochirurgia Polska 2008; 5 (1): 78–80
Online publish date: 2008/03/20
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We present a complex case of an 85-year-old woman with advanced coronary artery disease, renal failure and poor left ventricular function. The patient was unsuitable for percutaneous coronary intervention due to a complex and long stenotic lesion in the LAD artery. She underwent minimally invasive direct coronary artery bypass (MIDCAB). Before grafting, extensive endarterectomy of 4-5 cm length was required. This was performed on the beating heart via the MIDCAB incision and the artery was then reconstructed with a venous patch prior to grafting.
We discuss the potential benefits of the MIDCAB approach in the elderly and illustrate the feasibility of the technique despite complex coronary anatomy and poor LV function.
keywords:

MIDCAB, coronary artery bypass grafting, endarterectomy, perioperative infarction

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