No abstract

Background: Techniques of reduction aortoplasty are widely published in the literature with conflicting results. External support seems to be an important factor in preventing recurrence but, in some cases, this technique caused erosion of the aorta because of the wrinkles the prosthesis creates in the rear side of the aorta.

A 70-year-old male known with myelodysplastic syndrome (MDS) was admitted with effort angina and fever, which developed into unstable angina. On coronary angiography a critical stenosis of the left main coronary artery and 75% stenosis of the right coronary artery were found. On complete blood count the number of leukocytes was 1600/µl. We administered granulocyte colony-stimulating factor (G-CSF) twice daily to increase the number of leucocytes. After two days the number of leukocytes had increased to 8700/µl. The patient was admitted to the operating room and off-pump coronary artery bypass grafting was performed successfully.

We describe a case of 73-year-old patient who has been operated in emergency on triple coronary artery bypass graft (CABG), which was complicated with respiratory insufficiency and devastating mediastinitis. The anterior mediastinum was closed with an omental flap that was allowed to epithelize spontaneously. The patient was discharged after 110 days. Despite the large number of cases with mediastinitis described in the literature, the chest closure with only an omental flap without closure of subcutaneous tissue and skin is rare.