| A Case of Off-Pump Coronary Artery
Bypass for Acute Myocardial Infarction with Cardiogenic Shock |
(Department of Surgery III, Nara Medical University,
Kashihara, Japan)
| Takashi Ueda |
Tetsuji Kawata |
Hiroshi Naito |
| Michitaka Kimura |
Shigeki Taniguchi |
|
|
| A 67-year-old man was considered
a candidtate for CABG because coronary angiogram showed obstruction
segment 6 and stenoses of segments 9 and 12. He underwent emergency
CABG due to acute myocardial infarction (AMI) with cardiogenic
shock caused by hemorrhage from a gastric ulcer. Because of hypoxia
due to pulmonary edema and acute renal failure an intraaortic
baloon was inserted. He had a history of cerebrovascular stroke.
Although coronary angiogram revealed multiple vessel disease,
we performed off-pump coronary artery bypass (saphenous vein
graft-left anterior descending artery) for salvage, because cardiopulmonary
bypass was considered very risky and further systemic heparinization
might be fatal. He has returned to his job, and is now free from
angina. As AMI with cardiogenic shock is often caused by a lesion
in the LAD, CABG without cardiopulmonary bypass may be an effective
technique in certain selected patients. Jpn. J. Cardiovasc. Surg.
29: 339-342 (2000) |
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