Chest wall infarction following bilateral internal mammary to coronary arterial bypass in a patient with a thoracoabdominal aneurysm.
A 69-year-old man with severe peripheral vascular disease and a known thoracoabdominal aortic aneurysm underwent bilateral internal mammary artery (BIMA) to coronary artery bypass grafting and aortic hemiarch replacement. He immediately thereafter developed massive chest wall ischemia and infarction with a severe metabolic acidosis, and subsequently died. Chest wall infarction following BIMA harvesting has not been previously described. Cautious use of internal mammary arterial grafting may be in order in the severe vasculopath with significant thrombo-occlusive thoracoabdominal aortic disease.
Keyser
E J
EJ
Division of Cardiothoracic Surgery, Royal Victoria Hospital, McGill University, Montreal, Quebec, Canada.
Ergina
P L
PL
Melanson
P R
PR
de Varennes
B
B
D000368:Aged; D000792:Angiography; D017544:Aortic Aneurysm, Abdominal / Q000150:complications* / Q000175:diagnosis; D017545:Aortic Aneurysm, Thoracic / Q000150:complications* / Q000175:diagnosis; D002908:Chronic Disease; D003327:Coronary Disease / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D004452:Echocardiography; D017809:Fatal Outcome; D006801:Humans; D007238:Infarction / Q000209:etiology*; D007387:Internal Mammary-Coronary Artery Anastomosis / Q000009:adverse effects*; D008297:Male; D011183:Postoperative Complications; D013909:Thorax / Q000098:blood supply*; D014057:Tomography, X-Ray Computed