Coronary-Coronary Bypass Grafting to Reduce the Risk of Aortic Atheroembolism

Yalçınkaya, Adnan; Cagli, Kumral; Ulaş, Murat; Ökten, Sarper; Çağlı, Kerim

doi:10.1111/j.1540-8191.2009.00958.x

Cited by 3 publications

(2 citation statements)

References 10 publications

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“…Angiography showed graft patency one year after revascularization. Possibility of coronary-coronary bypasses grafting off-pump in patients with extensive atherosclerotic aorta was also described by Yalcikaya A. et al and Wan L.F. et al [5].…”

Section: History Of Coronary-coronary Bypass Grafting and Its Reporte...mentioning

confidence: 67%

Coronary-Coronary Bypass Grafting

Базылев¹,

Тунгусов²,

Mikulyak³

2022

Coronary Artery Bypass Grafting

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This work is devoted to the original method of myocardial revascularization—coronary-coronary bypass grafting. Coronary artery bypass grafting can be considered as an independent method in an exceptional case or as an addition to the standard coronary artery bypass grafting technique. This paper presents the technique for performing CCBG, as well as the early and long-term results of the main studies. Attention is also paid to the advantages and disadvantages of this method from the standpoint of physiology and physics.

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Section: History Of Coronary-coronary Bypass Grafting and Its Reporte...mentioning

confidence: 67%

Coronary-Coronary Bypass Grafting

Базылев¹,

Тунгусов²,

Mikulyak³

2022

Coronary Artery Bypass Grafting

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“…Agrifoglio et al [ 82 ] have identified a case in which CABG was performed off-pump and the saphenous vein graft was anastomosed proximally to the left common carotid artery. In addition to these methods, the coronary - coronary bypass is an alternative technique that can be used to bypass isolated atherosclerotic coronary lesions in the presence of PA[ 83 , 84 ]. In hemodynamically unstable patients or in whom aortic manipulation cannot be performed due to severely atherosclerotic aorta, performing CABG with the off-pump technique under CPB support and without application of CC can be a good choice to prevent neurologic complications[ 29 , 30 ].…”

Section: Pa and Cabgmentioning

confidence: 99%

Surgical strategies for severely atherosclerotic (porcelain) aorta during coronary artery bypass grafting

Şirin

2021

WJC

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Porcelain aorta (PA) is an asymptomatic atherosclerotic disease, characterized by circumferential calcification throughout the whole perimeter of the aorta. It is seen in 2% to 9.3% of patients undergoing elective coronary artery bypass grafting (CABG) and makes manipulation of the ascending aorta impossible. It has been clearly shown that most emboli seen and detected during the CABG procedure occur during aortic cross-clamping and aortic side-clamping. Manipulation of porcelain or a severely atherosclerotic aorta increases the risk of perioperative stroke. The incidence of stroke after CABG is between 0.48% and 2.9% , and the risk is correlated with the extent and severity of the atherosclerotic disease. A conventional CABG procedure involves successive steps that include cannulation of the ascending aorta, application of a cross-clamp to the aorta, and partial clamping of the aorta to create the proximal anastomosis. Therefore in procedures that involve cannulation, clamping, or proximal anastomosis, and where aortic manipulation is inevitable, preassessment of the atherosclerotic aortic plaques is crucial. Although many surgeons still rely on intraoperative manual aortic palpation, this approach has very low sensitivity and underestimates the severity of the atherosclerotic illness. Imaging methods including preoperative computed tomography or intraoperative epiaortic ultrasonography enable modification of the surgical technique according to the severity of atherosclerosis. Various surgical techniques have been described to reduce the risk of atheroembolism that may lead to cerebrovascular events in patients with severely atherosclerotic ascending aorta. Anaortic or “no-touch” techniques that do not utilize aortic manipulation may significantly decrease the development of neurological complications by avoiding aortic maneuvers known to cause emboli. In cases where severe atherosclerotic disease or other factors preclude safe use of the ascending aorta, modifications in the surgical techniques, such as switching to different cannulation sites including the axillary/subclavian, femoral and innominate arteries, or using hypothermic ventricular fibrillation and in-situ pedicled arterial grafts, or performing proximal anastomoses at alternative anatomical locations will enable CABG operations to be performed safely with low morbidity and mortality rates in patients with porcelain aortas.

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Surgical strategies for severely atherosclerotic (porcelain) aorta during coronary artery bypass grafting

Şirin¹

2021

WJC

View full text Add to dashboard Cite

Coronary-Coronary Bypass Grafting to Reduce the Risk of Aortic Atheroembolism

Cited by 3 publications

References 10 publications

Coronary-Coronary Bypass Grafting

Coronary-Coronary Bypass Grafting

Surgical strategies for severely atherosclerotic (porcelain) aorta during coronary artery bypass grafting

Surgical strategies for severely atherosclerotic (porcelain) aorta during coronary artery bypass grafting

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