title: Off-pump coronary artery bypass grafting via median sternotomy in a patient with a history of esophagectomy with substernal gastric tube reconstruction: report of a case.
abstract: We performed successful off-pump coronary artery bypass grafting (OPCAB) in a patient with unstable angina caused by triple-vessel disease, who had undergone esophagectomy with substernal gastric tube reconstruction for esophageal cancer 40 years earlier. Preoperative multidetector-row computed tomography was done to evaluate the course of the gastric tube and also that of the gastroepiploic artery, which feeds the gastric tube. Following careful sternal re-entry and adequate dissection, OPCAB was performed safely via a median sternotomy without injuring the gastric tube or causing hemodynamic instability. The patient had an uneventful early postoperative course.
authors.affiliation: Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine, Yamadaoka 2-2, Suita, Osaka, 565-0087, Japan.
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Kashiyama
authors.forename: Koichi
authors.initials: K
authors.lastname: Toda
authors.forename: Shigeru
authors.initials: S
authors.lastname: Miyagawa
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Nishi
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Yoshikawa
authors.forename: Satsuki
authors.initials: S
authors.lastname: Fukushima
authors.forename: Daisuke
authors.initials: D
authors.lastname: Yoshioka
authors.forename: Kawamura
authors.initials: K
authors.lastname: Masashi
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Saito
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Sawa
mesh_terms: D000368:Aged; D000789:Angina, Unstable / Q000601:surgery*; D047549:Coronary Artery Bypass, Off-Pump / Q000379:methods*; D004938:Esophageal Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery; D016629:Esophagectomy; D005774:Gastrostomy / Q000379:methods*; D006801:Humans; D008297:Male; D061330:Multidetector Computed Tomography; D019651:Plastic Surgery Procedures / Q000379:methods*; D056346:Sternotomy / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome