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ABSTRACT 46
OFF-PUMP INNOMINATE-CORONARY BYPASS IN PATIENTS
WITH ATHEROSCLEROTIC ASCENDING AORTA
Wilson Ko, M.D.
New York Hospital of Queens, Cornell University Weill Medical
College, New York, U.S.A.
Conventional aorto-coronary artery bypass surgery in patients
with severely atherosclerotic ascending aorta is at high risk
for neurologic injury. Off-pump technique using innominate artery
rather than the diseased ascending aorta for saphenous vein grafts
may prevent athero-embolic injuries.
Ten consecutive patients with porcelain aorta underwent off-pump
saphenous vein bypasses from innominate artery to various coronary
targets with or without using internal mammary artery. The average
age of the patients was 81. All patients had left main coronary
disease, and in unstable angina. Two patients were dialysis dependent.
The average bypass grafts was 2.3. The operating time was less
than 3 hours; all patients were extubated within 12 hours of surgery.
There were no incidences of neurologic injury or other thromboembolic
organ damage. There was no perioperative myocardial infarction.
The median postoperative length of stay was 6 days. All patients
were doing well and free of angina at a median follow up of 5
months.
Off-pump innominate-coronary bypass is an important adjunct in
the management of patients porcelain ascending aorta.
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