Off-pump coronary surgery for allograft vasculopathy 8 years after heart transplant.
Cardiac allograft vasculopathy is a severe complication after heart transplant, and is the major cause of death in patients surviving 1 year after transplant. We present a 59-year-old patient undergoing off-pump, coronary artery bypass surgery, 8 years after heart transplant. Owing to toxic liver disease, the lipid lowering therapy with statins had to be stopped 6 years after transplant, and coronary artery disease developed rapidly within 2 years. Off-pump, coronary bypass surgery was performed using a new, multisuction cardiac positioner; a disposable stabilizer; and a proximal seal system to avoid clamping of the aorta. The patient received 3 bypass grafts: the left internal thoracic artery; to the left anterior descending coronary artery; 1 saphenous vein graft to the marginal branch of the circumflex artery; and 1 saphenous vein graft to the right coronary artery. His postoperative course was uneventful.
Michel
Sebastian
S
Department of Cardiac Surgery, Grosshadern University Hospital, LM-University, Munich, Germany.
Kaczmarek
Ingo
I
Beiras-Fernandez
Andres
A
Ueberfuhr
Peter
P
Abicht
Jan
J
Reichart
Bruno
B
Vicol
Calin
C
D047549:Coronary Artery Bypass, Off-Pump / Q000295:instrumentation; D003324:Coronary Artery Disease / Q000209:etiology / Q000601:surgery*; D016027:Heart Transplantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D014184:Transplantation, Homologous; D016896:Treatment Outcome