The heavily calcified aorta and re-do CABG surgery: technical considerations how to avoid aortic crossclamp. How-to-do-it.
Aortic crossclamp may increase the risk for acute aortic dissection and embolic stroke in patients with severe aortic calcification. Additionally, in CABG re-operation aortic crossclamp may necessitate extensive dissection of fibrous adhesions which may intensify the potential risk of injury to the aorta, pulmonary artery or patent bypass grafts. Therefore, it appears to be advantageous in patients undergoing re-do CABG or with aortic calcification to minimize surgical manipulation of the aorta by abandonment of aortic crossclamp. Adequate myocardial protection and convenient surgical exposure without aortic crossclamp max be achieved by intraaortic administration of the short acting ss-blocker esmolol.
Kuhn-Régnier
Ferdinand
F
Department of Cardiothoracic Surgery, University of Cologne, Joseph-Stelzmannstr 9, 50924, Cologne, Germany. Ferdinand.Kuhn-Regnier@medizin.unikoeln.de
Geissler
Hans J
HJ
Mehlhorn
Uwe
U
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000368:Aged; D001018:Aortic Diseases / Q000150:complications*; D002114:Calcinosis / Q000150:complications*; D002316:Cardiotonic Agents / Q000627:therapeutic use; D003250:Constriction; D001026:Coronary Artery Bypass / Q000379:methods*; D006801:Humans; D007430:Intraoperative Care / Q000379:methods; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control; D011412:Propanolamines / Q000627:therapeutic use; D012086:Reoperation / Q000379:methods
D000319:Adrenergic beta-Antagonists; D002316:Cardiotonic Agents; D011412:Propanolamines; C036604:esmolol