Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia
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Ann Thorac Cardiovasc Surg · Aug 2010
Safe approach for redo coronary artery bypass grafting--preventing injury to the patent graft to the left anterior descending artery.
In redo coronary artery bypass grafting (CABG), repeat median sternotomy is a routine approach when the graft to the left anterior descending artery (LAD) is occluded. However, it is important to avoid injury to the patent graft to LAD during repeat sternotomy. We retrospectively reviewed our cases to assess our combined strategy for a safer redo CABG. ⋯ According to the circumstances, conduits and a proximal anastomosis should be selected. For redo CABG patients who have a patent graft to LAD, it is important to choose the optimal approach to avoid injury to the previous patent graft.
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Ann Thorac Cardiovasc Surg · Aug 2010
Case ReportsSuccessful surgical repair of an infectious thoracic aortic pseudoaneurysm accompanied by aortobronchopulmonary fistula and advanced hepatic dysfunction without assisted circulation.
The patient was a 59-year-old female. Because of massive hemoptysis, she was brought to our emergency center by ambulance. Thoracic computed tomography led to a diagnosis of an infectious thoracic aortic pseudoaneurysm accompanied by an aortobronchopulmonary fistula. ⋯ A patch plasty using expanded polytetrafluoroethylene completed the procedure. Streptococcus agalactiae (GBS) was detected in a sample obtained during the surgery from an abscess located in the aneurysm. The patient made satisfactory postoperative progress and left the hospital walking unaided on the 36th postoperative day.