"Off-pump" repair of a postangioplasty coronary artery bleed.
Following percutaneous multivessel coronary stent implantation with full anticoagulation, a 65-year-old man suffered tamponade and cardiac arrest. After successful resuscitation, he underwent repeat coronary angiography which demonstrated extravasation of contrast from a distal circumflex subbranch. Thereafter, he was transferred to the cardiothoracic surgery unit where the leaking vessel was oversewn using the Medtronic Octopus Retractor for stabilization. This report illustrates the growing wider use of "off-pump" techniques beyond coronary artery bypass grafting. In this case, the patient was exposed to a much shorter procedure with less morbidity than could have been expected had cardiopulmonary bypass been used.
Devey
Luke R
LR
Department of Cardiothoracic Surgery, Royal Infirmary of Edinburgh, Little France Crescent, Edinburgh. devey@doctors.org.uk
Shaw
Thomas R D
TR
Zamvar
Vipin
V
D000368:Aged; D000789:Angina, Unstable / Q000000981:diagnostic imaging / Q000628:therapy*; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects* / Q000379:methods; D000925:Anticoagulants / Q000009:adverse effects* / Q000627:therapeutic use; D016887:Cardiopulmonary Resuscitation / Q000379:methods; D017023:Coronary Angiography; D047549:Coronary Artery Bypass, Off-Pump / Q000379:methods*; D003331:Coronary Vessels; D015150:Echocardiography, Doppler; D005500:Follow-Up Studies; D006323:Heart Arrest / Q000209:etiology / Q000628:therapy; D006470:Hemorrhage / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D008297:Male; D018570:Risk Assessment; D012720:Severity of Illness Index; D015607:Stents; D016896:Treatment Outcome
D000925:Anticoagulants