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. 1998;25(2):120–123.

A no-touch technique for calcified ascending aorta during coronary artery surgery.

B Akpinar 1, M Güden 1, I Sanisoğlu 1, C Konuralp 1, O Yilmaz 1, B Sönmez 1
PMCID: PMC325523  PMID: 9654656

Abstract

Despite improvements in cardiovascular surgery techniques over the years, the incidence of neurologic complications has not declined, and stroke remains a possible (and devastating) sequela to coronary artery surgery. In this report, we describe a moderate hypothermic fibrillatory arrest technique that avoids cross-clamping or otherwise touching the aorta; use of the internal thoracic arteries and the right gastroepiploic artery provides optimum revascularization and minimizes the risk of cerebrovascular accident. Over a 1-year period, we used the technique in 21 patients who had heavy calcifications of the ascending aorta. No hemodynamic problems, lower-limb ischemia, or neurologic complications were seen. Only 1 patient underwent reoperation (for bleeding), and another--whose revascularization was incomplete--had a high postoperative level of myocardial creatine kinase MB isoenzyme and a new Q wave, but no hemodynamic deterioration. This technique seems reasonable, because it appears to provide good myocardial protection and to reduce neurologic complications, without comprising myocardial revascularization.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

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