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.
Pocar
Marco
M
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
Moneta
Andrea
A
Passolunghi
Davide
D
Donatelli
Francesco
F
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