Coronary surgery in patients with porcelain aorta.
Four patients with unstable angina due to left main or three-vessel disease scheduled for coronary artery bypass grafting were found intra-operatively to have porcelain ascending aorta, defined as massive calcification of the ascending aorta from the aortic valve to the transverse arch, precluding ascending aorta cannulation or clamping. A no-touch operative technique was applied using the two internal mammary arteries in three cases, with complementary Y-grafting when necessary. Three cases underwent off-pump myocardial revascularization. The fourth case was revascularized with pump-assisted beating heart and proximal saphenous graft anastomosis with an automatic connector. There was no mortality or neurologic morbidity and all patients were discharged home before post-operative day 8.
Hospital da Cruz Vermelha Portuguesa, Lisboa. uvamiguel@hotmail.com
Miguel Sousa
MS
Uva
Albino
A
Pedro
Rui
R
Caria
Armindo
A
Mesquita
José
J
Bau
João
J
Pinho
Judith
J
Fernandes
Manuel Pedro
MP
Magalhães
D000368:Aged; D000369:Aged, 80 and over; D000789:Angina, Unstable / Q000209:etiology; D001011:Aorta / Q000601:surgery; D001018:Aortic Diseases / Q000150:complications / Q000601:surgery*; D002114:Calcinosis / Q000150:complications / Q000601:surgery*; D001026:Coronary Artery Bypass / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male