Aortic valve replacement in a patient with a patent internal thoracic artery graft.

Ueda, Takashi; Kawata, Tetsuji; Sakaguchi, Hidehito; Tabayashi, Nobuoki; Abe, Takehisa; Hirose, Tomoaki; Taniguchi, Shigeki · Ann Thorac Surg · 2004

case_report · Level V

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Abstract

Myocardial protection in patients requiring a second open-heart surgical procedure after coronary artery bypass grafting, especially when there is a patent left internal thoracic artery graft to the left anterior descending coronary artery, remains controversial. We present the case of a patient in whom aortic valve replacement was undertaken 18 months after coronary artery revascularization. Unusual features included beating-heart aortic valve replacement with continuous retrograde coronary sinus perfusion and avoidance of dissection of the patent grafts, including the left internal thoracic artery and a saphenous vein graft.

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