title: An unusual origin of proximal coronary bypass anastomosis in a patient with porcelain aorta: how we solved the problem.
abstract: Severe calcification of the ascending aorta (porcelain aorta) is a very difficult condition in cardiac surgery because of a high embolization potential during the process of cannulation, aortic cross-clamping and a particular difficulty to suture the proximal anastomosis. We described a case of a 68-year-old female referred to our Institute due to unstable angina. Further diagnostics revealed a severe high grade, multilevel fibrolipid symptomatic carotid stenosis and ostial left main coronary artery stenosis and a highly calcified ascending aorta and aortic arch. We performed simultaneous carotid segment replacement with the Dacron prosthesis and revascularisation of the left anterior descending coronary artery. Proximal venous anastomosis was created in the Dacron prosthesis of the right carotid artery. Perfusion of the patient was achieved via the graft sutured at the right subclavian artery due to impossibility of direct aortic cannulation.
authors: Department of Cardiovascular Surgery, Insitute of Cardiovascular Diseases of Vojvodina, Sremska Kamenica. andrej.lara@gmail.com
authors: Pavle
authors: P
authors: Kovacević
authors: Lazar
authors: L
authors: Velicki
authors: Aleksandar
authors: A
authors: Redzek
authors: Miodrag
authors: M
authors: Golubović
authors: Viktor
authors: V
authors: Till
authors: Vladimir
authors: V
authors: Ivanović
mesh_terms: D000368:Aged; D000789:Angina, Unstable / Q000150:complications / Q000601:surgery*; D001018:Aortic Diseases / Q000150:complications*; D019917:Blood Vessel Prosthesis Implantation; D002114:Calcinosis / Q000150:complications*; D002340:Carotid Artery Diseases / Q000150:complications / Q000601:surgery; D002343:Carotid Artery, Internal / Q000601:surgery; D001026:Coronary Artery Bypass / Q000379:methods*; D016894:Endarterectomy, Carotid; D005260:Female; D006801:Humans