title: Aortic valve replacement in a patient with a patent internal thoracic artery graft.
abstract: Myocardial protection in patients requiring a second open-heart surgical procedure after coronary artery bypass grafting, especially when there is a patent left internal thoracic artery graft to the left anterior descending coronary artery, remains controversial. We present the case of a patient in whom aortic valve replacement was undertaken 18 months after coronary artery revascularization. Unusual features included beating-heart aortic valve replacement with continuous retrograde coronary sinus perfusion and avoidance of dissection of the patent grafts, including the left internal thoracic artery and a saphenous vein graft.
authors.affiliation: Department of Surgery III, Nara Medical University, Nara, Japan. u-taka@naramed-u.ac.jp
authors.forename: Takashi
authors.initials: T
authors.lastname: Ueda
authors.forename: Tetsuji
authors.initials: T
authors.lastname: Kawata
authors.forename: Hidehito
authors.initials: H
authors.lastname: Sakaguchi
authors.forename: Nobuoki
authors.initials: N
authors.lastname: Tabayashi
authors.forename: Takehisa
authors.initials: T
authors.lastname: Abe
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Hirose
authors.forename: Shigeki
authors.initials: S
authors.lastname: Taniguchi
mesh_terms: D000368:Aged; D000784:Aortic Dissection / Q000601:surgery; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery; D001022:Aortic Valve Insufficiency / Q000601:surgery*; D001158:Arteries / Q000637:transplantation*; D001705:Bioprosthesis; D002315:Cardiopulmonary Bypass; D003131:Combined Modality Therapy; D001026:Coronary Artery Bypass; D023921:Coronary Stenosis / Q000601:surgery*; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D010477:Perfusion; D011183:Postoperative Complications / Q000601:surgery*; D012086:Reoperation / Q000379:methods; D014654:Vascular Patency / Q000502:physiology*; D014680:Veins / Q000637:transplantation