We performed off pump CABG (coronary artery bypass grafting) and right upper lobectomy with R2a lymph nodes dissection on the patient suffered from both lung cancer in the right S1 and stenotic lesion in the left anterior descending artery. Because the coronary lesion was long-segmented one, it was not suitable for percutaneous transluminal coronary angioplasty. To perform absolutely curative operation for the lung cancer, CABG was undergone simultaneously under off pump condition. It is generally feared that the cardiovascular surgery under CPB may have adverse effect for the patient with malignant lesion. Off pump CABG is expected to avoid such disadvantage of CPB, and thought to be suitable method for such a patient as we present above.
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Department of Cardiovascular Surgery, Nihon University School of Medicine, Tokyo, JPN.
Left ventricular (LV) thrombus is a serious complication of myocardial infarction (MI) that can lead to a fetal systemic embolism. Although coronary artery bypass graft surgery (CABG) after MI is widely performed, to our knowledge, there are no reports of LV thrombus in the early postoperative period. Here, we report a rare case of a 70-year-old man who underwent off-pump coronary artery bypass grafting (OPCAB) for unstable angina pectoris with reduced left ventricular ejection fraction (LVEF).
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Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
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Off-pump coronary artery bypass grafting (CABG), developed to avoid the potential complications of cardiopulmonary bypass, remains a subject of debate. Studies have demonstrated that off-pump CABG is associated with higher rates of incomplete revascularization, inferior graft patency, and increased reintervention rates compared to on-pump CABG, leading to worse outcomes. The theoretical neuroprotective and renal-protective benefits associated with off-pump CABG have not been definitively proven, with stroke and renal failure rates similar to those of on-pump CABG in both short- and long-term follow-up.
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