Near-fatal kinking of mammary graft due to emphysematous lung disease
| Autor: | Valerie A McRae, Sajjad Ibrar, Sagar S. Mungekar, Joyce A. Bonitz, Geza K. Kiss, Shaul Cohen, James Tse, John T. Denny, Benjamin R Landgraf |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
Sternum Saphenous vein graft Pulmonary disease Hemodynamics Case Report 030204 cardiovascular system & hematology CABG complications Cardiovascular surgery 03 medical and health sciences 0302 clinical medicine medicine 030212 general & internal medicine coronary graft problems anesthesia/pain lcsh:R5-920 Left internal mammary artery business.industry General Medicine Surgery medicine.anatomical_structure surgical procedures operative Lung disease Complication business lcsh:Medicine (General) Artery |
| Zdroj: | SAGE Open Medical Case Reports, Vol 6 (2018) SAGE Open Medical Case Reports |
| Popis: | Left internal mammary artery grafting is commonly used in elective coronary artery bypass graft surgery. We report a near-fatal case with graft kinking upon sternal closure due to distended, emphysematous lungs impinging on the mammary graft. After the sternum was closed, the patient suffered a severe hemodynamic deterioration. Surgical examination revealed kinking of his left internal mammary artery upon sternal closure due to distended, emphysematous lungs impinging on the mammary graft. Using an off-bypass technique, the kink in the mammary graft to the left anterior descending artery was removed by moving the origin of the left internal mammary artery to a hooded graft of a saphenous vein graft instead. In this position, the graft no longer was impinged upon by the distended emphysematous lungs. Subsequently, the patient’s sternum was closed without hemodynamic impingement. Although chronic obstructive pulmonary disease is well described to increase complications in coronary artery bypass graft surgery, it has not been previously associated with the kinking of a left internal mammary artery. This report highlights another contribution that chronic obstructive pulmonary disease can make to increased morbidity following coronary artery bypass graft surgery and alerts readers to watch for this complication in susceptible patients. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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