CCECC for CABG is associated with a significant reduction of red blood cell damage and activation of coagulation cascades similar to OPCAB when compared with conventional CPB while a delayed fibrinolytic and inflammatory activity was observed. These findings require further investigation to verify the promising concept of CCECC.
The intimal lesions observed after tourniquet occlusion in our experimental off-pump surgery model confirmed other recent studies. In contrast, utilization of TILS caused only minor damage of the vessel wall. The endothelial abrasions detected in this group may be a consequence of micro-dislocations or insertion maneuvers. Chronic studies are necessary to verify as to whether the mild injury after TILS insertion will result in a reduction or even absence of de-novo stenoses compared with tourniquet occlusion.
In a male patient, presenting with progressive angina refractory to medical treatment, a solitary aneurysm of the left main coronary artery without fistula, a 2 cm large atrial septal defect (ASD) and a persisting left superior caval vein were diagnosed. Successful resection with subsequent in situ repair by vein grafting of the left anterior descending artery and the circumflex coronary artery system and direct closure of the ASD are described.
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