Beating-heart ascending aortic graft replacement in dilated cardiomyopathy.
It is still a highly difficult choice with no definitive answer whether to perform cardiac surgery on cardioplegically arrested heart or to operate on a beating heart, especially for patients with dilated cardiomyopathy (DCM). A 73-year-old man, who had ascending aortic aneurysm and DCM with ejection fraction (EF) of 16.5% and the left ventricle (LV) dyssynchrony, underwent graft replacement of the ascending aorta and implantation of the LV lead for cardiac resynchronization. The operation was carried out on a beating heart using tepid hypothermic cardiopulmonary bypass under antegrade/retrograde coronary blood perfusion during graft-aorta proximal anastomosis. Postoperative course was uneventful, though brain natriuretic peptide (BNP) showed transient elevation.
Imagawa
Hiroshi
H
Organ Regenerative Surgery, Ehime University School of Medicine, To-on, Ehime 791-0295, Japan. imagawa@m.ehime-u.ac.jp
Shikata
Fumiaki
F
Ryugo
Masahiro
M
Kawachi
Kanji
K
D000368:Aged; D001014:Aortic Aneurysm / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001145:Arrhythmias, Cardiac / Q000209:etiology / Q000628:therapy; D019917:Blood Vessel Prosthesis Implantation; D002304:Cardiac Pacing, Artificial; D002311:Cardiomyopathy, Dilated / Q000150:complications*; D002315:Cardiopulmonary Bypass; D006801:Humans; D007036:Hypothermia, Induced; D008297:Male; D010477:Perfusion; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome