Femoro-axillary cardiopulmonary bypass for giant abdominal aortic aneurysm repair prior to staged cardiac operation for ischaemic cardiomyopathy.
The optimal surgical management of simultaneous abdominal aortic aneurysm and cardiac disease remains a major challenge in case of larger aneurysms and severe cardiac disease. In case of symptomatic aneurysms or impending rupture, a single-stage combined operation is the most widely accepted procedure. We report the successful use of closed-chest cardiopulmonary bypass, with femoral venous and axillary arterial peripheral cannulation, to support cardiac function on the beating heart during resection of a giant abdominal aortic aneurysm and ischaemic cardiomyopathy. One month later, the patient underwent a second-stage deferred cardiac operation, consisting of triple coronary bypass grafting, undersized mitral annuloplasty and epicardial left ventricular lead implantation for cardiac resynchronisation therapy.
Dipartimento di Scienze Cardiovascolari, Università degli Studi di Milano, IRCCS MultiMedica, Via Milanese 300, I-20099 Sesto San Giovanni, Milan, Italy. marco.pocar@unimi.it
Marco
M
Pocar
Andrea
A
Moneta
Davide
D
Passolunghi
Francesco
F
Donatelli
D000368:Aged; D015901:Angiography, Digital Subtraction; D017544:Aortic Aneurysm, Abdominal / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D002315:Cardiopulmonary Bypass / Q000379:methods*; D001026:Coronary Artery Bypass / Q000379:methods; D006801:Humans; D008297:Male; D017202:Myocardial Ischemia / Q000150:complications / Q000601:surgery*; D014057:Tomography, X-Ray Computed