Perioperative Avulsion of a Left Internal Mammary Artery Graft in a Patient with Syphilis

Kaleda, Vasily I.; Белаш, С. А.; Barsuk, Alexei V.; Barbuhatti, K. O.

doi:10.1155/2014/574346

Cited by 3 publications

(5 citation statements)

References 14 publications

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“…LIMA graft avulsion post-conventional CABG surgery has been reported twice in the literature. 6 , 7 In these reported cases, transection of the LIMA graft had occured within the first few hours of the operation. On the contrary, in our case, this complication happened late after the surgery.…”

Section: Discussionmentioning

confidence: 91%

“…As mentioned above, the reported time interval between the conventional CABG operation and the graft avulsion has been very short; 1.5 h 7 and 3 h post-surgery. 6 In MIDCAB setting however the time interval has been variable; as short as 6 h post-operation following closed-chest CPR, 3 13 days post-operation following vigorous stretching exercise, 2 18 days post-operation, 5 and up to 3 months post-operation.…”

Section: Discussionmentioning

confidence: 96%

“…Ten years later in 2014 Kaleda et al . 7 reported peri-operative avulsion of the LIMA to LAD at 1.5 h post-conventional CABG surgery and again 9 h after emergency re-insertion of the ruptured LIMA to the LAD artery. Following rupture of the LIMA graft for the second time, the LAD was bypassed with a vein graft.…”

Section: Discussionmentioning

confidence: 97%

“…Interaction of the artery with the edge of the pericardium, inadequate side branch clipping, and adhesion of the conduit to the surrounding anatomical structures such as chest wall, mediastinum, or lung makes LIMA susceptible to excessive traction. 7 Adequate mobilization of the conduit will enable it to adapt with slight variations of chest wall amplitude, lungs, or diaphragm excursion. 2 Rupture of the LIMA graft can occur during weaning from the ventilator when sudden forceful lung expansion happens and results in contact of the lung edge with the graft with a considerable force.…”

Section: Discussionmentioning

confidence: 99%

“… 6 Cardiopulmonary resuscitation, hyperventilation, coughing, sneezing, blunt trauma, and weightlifting have also been named as possible causes. 7 , 8 In patients with chronic lung disease, LIMA should be harvested long enough by making a fasciotomy to the LIMA or by extending the length of skeletonization. 6 Graft tension can be reduced in these patients by creating a fissure in the lung to allow passage of the graft.…”

Section: Discussionmentioning

confidence: 99%

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Successful percutaneous treatment of a catastrophic left internal mammary artery graft avulsion occurring 4 weeks post-coronary artery bypass grafting surgery: a case report

Tehrani

Rathore

2020

European Heart Journal - Case Reports

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Background Avulsion of the left internal mammary artery (LIMA) graft near the anastomosis to the left anterior descending artery (LAD) artery post-coronary artery bypass grafting (CABG) is a rare but potentially catastrophic complication which can result in sudden ischaemia, haemodynamic compromise and life-threatening bleeding into the pericardium. Case summary We report a case of a spontaneous LIMA graft avulsion at the site of the anastomosis to the LAD artery, which occurred 4 weeks post-conventional CABG surgery and resulted in anterior myocardial infarction (MI), cardiac tamponade and cardiogenic shock. This life-threatening event was treated by deploying a covered stent in the LAD artery and by coiling the dehisced LIMA graft. Discussion To our knowledge, this is the first report of late LIMA graft avulsion that has been uniquely and successfully treated by percutaneous coronary intervention.

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Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Successful percutaneous treatment of a catastrophic left internal mammary artery graft avulsion occurring 4 weeks post-coronary artery bypass grafting surgery: a case report

Tehrani

Rathore

2020

European Heart Journal - Case Reports

View full text Add to dashboard Cite

show abstract

Spontaneous avulsion of left internal mammary artery graft a complication of coronary artery bypass surgery: case report and review of the literature

Nairat,

Akram,

Alaqra

et al. 2024

J Cardiothorac Surg

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Background Coronary artery bypass grafting (CABG) surgery is a common procedure for managing multi-vessel coronary artery disease to revascularize the myocardium. Among the various conduits used, the left internal mammary artery (LIMA) is preferred due to its better long-term patency rate. However, CABG procedures involving LIMA may result in rare but serious complications, such as avulsion of the LIMA post-CABG, which leads to disruption of blood flow to the myocardium and the development of fatal cardiac tamponade. Case presentation We hereby present a unique case of spontaneous avulsion of a LIMA graft to the left anterior descending artery (LAD) away from the site of anastomosis, twenty-four hours following CABG surgery in a 67-year-old male patient. Emergency re-exploration and repair of the LIMA with interposition vein graft were performed and resulted in successful stabilization of the patient’s critical condition. However, this was followed by a complicated recovery period involving atrial fibrillation, acute kidney injury, and wound infection. Conclusion Avulsion of LIMA graft following CABG is rare, yet a fatal complication that requires high clinical suspicion and prompt management. Avulsion has been reported a few times in literature following both minimal invasive and conventional CABG. Understanding the etiology, clinical presentation, and management of this complication is crucial to avoid catastrophic outcomes.

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Spontaneous Avulsion of Left Internal Mammary Artery Graft a Complication of Coronary Artery Bypass Surgery: Case Report and Review of the literature.

Nairat,

Akram,

Alaqra

et al. 2024

Preprint

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Background: Coronary artery bypass grafting (CABG) surgery is a common procedure for managing multi-vessel coronary artery disease to revascularize the myocardium. Among the various conduits used, the left internal mammary artery (LIMA) is preferred due to its better long-term patency rate. However, CABG procedures involving LIMA may lead to rare but serious complications, such as avulsion of the LIMA post-CABG, which leads to disruption of blood flow to the myocardium and the development of fatal cardiac tamponade. Case presentation: We present a unique case of spontaneous avulsion of LIMA graft to left anterior descending artery (LAD) away from the site of anastomosis twenty-four hours following CABG surgery in 67-year-old male patient. Emergency re-exploration and repair of the LIMA with interposition vein graft were performed, which successfully stabilized the patient critical condition followed by a complicated recovery period involving atrial fibrillation, acute kidney injury, and wound infection. Conclusion: Avulsion of LIMA graft following CABG is rare, however a fatal complication that requires high clinical suspicion and prompt management. Avulsion has been reported few times in the literature following both minimal invasive and conventional CABG. Understanding the etiology, clinical presentation, and management of this complication is crucial to avoid catastrophic outcomes.

show abstract

Perioperative Avulsion of a Left Internal Mammary Artery Graft in a Patient with Syphilis

Cited by 3 publications

References 14 publications

Successful percutaneous treatment of a catastrophic left internal mammary artery graft avulsion occurring 4 weeks post-coronary artery bypass grafting surgery: a case report

Successful percutaneous treatment of a catastrophic left internal mammary artery graft avulsion occurring 4 weeks post-coronary artery bypass grafting surgery: a case report

Spontaneous avulsion of left internal mammary artery graft a complication of coronary artery bypass surgery: case report and review of the literature

Spontaneous Avulsion of Left Internal Mammary Artery Graft a Complication of Coronary Artery Bypass Surgery: Case Report and Review of the literature.

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