Bentall Procedure with Concomitant Coronary-Coronary Bypass for Right Coronary Artery Stenosis: A Case Report

Authors

1 Student Research Committee, Faculty of Medicine,Mashhad University of Medical Sciences,Mashhad, Iran

2 Medical Student, Faculty of Medicine,Mashhad University of Medical Sciences,Mashhad, Iran

3 Assistant Professor of Cardiovascular Surgery, Atherosclerosis Prevention Research Center, ImamReza Hospital,Mashhad University of Medical Sciences,Mashhad, Iran

4 Assistant Professor of Cardiovascular Surgery, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran

5 Cardiovascular Research Center, Student Research Committee, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

Abstract

Abstract Introduction: Aortic surgery hasmademuch progress recently. Yet the combination of aortic surgery and coronary artery bypass grafting has remained amajor issue for the surgeons. Patient and Observation: Herein, we present a case of severe aortic insufficiency with aortic aneurysm concomitant with single coronary artery disease on the right coronary artery. The patient underwent Bentall procedure for the correction of severe AI and aortic aneurysm. Subsequently, due to the lack of proper site for proximal anastomosis of the saphenous veingraft on the ascending aorta, we decided to performcoronary-coronary artery bypass for the right coronary artery lesion instead of conventional implan- tation of saphenous vein graft on the ascending aorta. Conclusions: Coronary-coronary artery bypass could be performed safely for special conditions like porcelain aorta and when the ascending aorta is not suitable for the proximal saphenous vein graft.

Keywords


  1. 1.Freitas AC, Saporito WF, Donelli LA, Breda JR, Machado LN, Horiuti L, et al. Right coronary bypass grafting with coronary-coronary venous bypass graft. Rev Bras Cir Cardiovasc. 2009;24(3):401–3. [PubMed: 20011890].

    1. Barboso G, Rusticali F. Proximal internal mammary in situ graft and distal coronary-coronary graft. Tex Heart Inst J. 2000;27(1):70–1. [PubMed: 10830636].
    2. Moeinipour A, Amouzeshi A, Hoseinikhah H. Coronary artery bypass surgery in coronary artery disease concomitant with porcelain aorta: Great challenge for cardiac surgeon. Official quarterly publication of the iranian heart association; .
    3. Hagan PG, Nienaber CA, Isselbacher EM, Bruckman D, Karavite DJ, Russman PL, et al. The International Registry of Acute Aortic Dissection (IRAD): new insights into an old disease. JAMA. 2000;283(7):897– 903. [PubMed: 10685714].
    4. Trimarchi S, Nienaber CA, Rampoldi V, Myrmel T, Suzuki T, Mehta RH, et al. Contemporary results of surgery in acute type A aortic dissection: The International Registry of Acute Aortic Dissection experience. J Thorac Cardiovasc Surg. 2005;129(1):112–22. doi: 10.1016/j.jtcvs.2004.09.005. [PubMed: 15632832].
    5. Coady MA, Davies RR, Roberts M, Goldstein LJ, Rogalski MJ, Rizzo JA, et al. Familial patterns of thoracic aortic aneurysms. Arch Surg. 1999;134(4):361–7. [PubMed: 10199307].
    6. Moeinipour A, Fathi M, Sepehri Shamloo A, Amini S, Hoseinikhah H, Kianinejad A. Mediastinal packing for intractable coagulopathy in acute aortic dissection (types 1 and 2 debakey): A life-saving technique report of experiences. Case Rep Crit Care. 2015;2015.
    7. Korkmaz AA, Onan B, Tamtekin B, Oral K, Aytekin V, Bakay C. Right coronary revascularization by coronary-coronary bypass with a segment of internal thoracic artery. Tex Heart Inst J. 2007;34(2):170–4. [PubMed: 10830636].
    8. Nomura F, Ohno T. In situ coronary-coronary bypass grafting for a huge left coronary aneurysm. Ann Thorac Cardiovasc Surg. 2014;20 Suppl:622–4. doi: 10.5761/atcs.cr.13-00101. [PubMed: 23995349]. Razavi Int J Med. 2016; 4(4):e37803. 3 Hoseinikhah H et al.
    9. Omay O, Ozker E, Indelen C, Suzer K. Revascularization of left anterior descending (LAD) artery with in situ left internal thoracic artery (LITA) and coronary-coronary free LITA grafts: 12-year patency. J Card Surg. 2008;23(6):722–4. doi: 10.1111/j.1540-8191.2008.00643.x. [PubMed: 19017000].
    10. Nezic D, Knezevic A, Cirkovic M, Jovic M, Mangovski L, Milojevic P. [In situ pedicle graft and coronary-coronary bypass grafting using internal thoracic artery in management of multiple lesions of the left anterior descending coronary artery]. Med Pregl. 2004;57(11-12):601–4. [PubMed: 16107010].
    11. Nezic D, Knezevic A, Borovic S, Cirkovic M, Milojevic P. Coronarycoronary free internal thoracic artery graft on a single, distal, left anterior descending artery lesion. J Thorac Cardiovasc Surg. 2004;127(5):1517–8. doi: 10.1016/j.jtcvs.2003.11.022. [PubMed: 15116019].
    12. Nezic D, Knezevic A, Cirkovic M, Vukovic P, Jovic M. Perfect angiographic patency of the arterial coronary-coronary conduit five years following surgery. Thorac Cardiovasc Surg. 2009;57(5):307–8. doi: 10.1055/s-2008-1039208. [PubMed: 19629896].