title: Use of extracorporeal life support for emergency coronary artery bypass grafting.
abstract: A 14-year old boy was admitted with an anomalous origin of the right coronary artery (RCA) from the left sinus of Valsalva, with an interarterial course of the narrow proximal segment. He underwent coronary ostial augmentation and main pulmonary artery translocation to the left pulmonary artery. In the post-cardiopulmonary bypass (CPB) period, he developed thrombotic occlusion of the RCA resulting in arrhythmia and ventricular dysfunction, requiring extracorporeal life support (ECLS) in the form of extracorporeal membrane oxygenation rather than CPB. After confirming this complication by cardiac catheterization, the right coronary artery territory was revascularized with a pedicled right internal thoracic artery graft. The entire procedure was performed on a beating heart using a stabilizer during ECLS. This strategy may be useful in situations with unstable haemodynamics and a low risk of blood loss.
authors.affiliation: Department of Paediatric Cardiac Surgery, Mater Children's Hospital, South Brisbane, Queensland, Australia. drbiswapanda@gmail.com
authors.forename: Biswa Ranjan
authors.initials: BR
authors.lastname: Panda
authors.forename: Anil
authors.initials: A
authors.lastname: Prabhu
authors.forename: Sylvio
authors.initials: S
authors.lastname: Provenzano
authors.forename: Tom
authors.initials: T
authors.lastname: Karl
mesh_terms: D000293:Adolescent; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D002315:Cardiopulmonary Bypass; D017023:Coronary Angiography / Q000379:methods; D001026:Coronary Artery Bypass; D003326:Coronary Circulation; D003328:Coronary Thrombosis / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D003330:Coronary Vessel Anomalies / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D004630:Emergencies; D015199:Extracorporeal Membrane Oxygenation; D006439:Hemodynamics; D006801:Humans; D008297:Male; D012850:Sinus of Valsalva / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: Cardiac catheterization; Coronary artery bypass grafting; Extracorporeal life support; Extracorporeal membrane oxygenation