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The 10 Commandments for Proximal Anastomosis During CABG: Techniques and Technologies for Vein and Arterial Grafts
In coronary artery bypass grafting (CABG), the proximal anastomosis and management of the ascending aorta are critical moments that significantly influence the risk of perioperative stroke, due to the potential for cerebral embolization from dislodged aortic debris or hypoperfusion caused by hypotension.Perioperative stroke remains one of the most severe complications of CABG, leading to significant morbidity, mortality, and economic burden.
Authors
Massimo Baudo, Gianluca Torregrossa, and John D. Puskas
Coronary artery bypass grafting (CABG), introduced and pioneered over 50 years ago at the Cleveland Clinic by Dr. Rene Favalloro, has remained the gold standard in the treatment of multivessel coronary artery disease with heavy atherosclerotic burden. While utilizing the internal thoracic artery (ITA) to bypass the left anterior descending artery (LAD) has been the cornerstone of CABG since 1986, there has been growing consensus on the importance of multiarterial grafting (MAG) with the use of at least 2 arterial grafts, resulting in improved survival and freedom from major adverse cardiac events including reinterventions
Minimally invasive surgical coronary artery bypass in women
Minimally invasive coronary artery bypass grafting (CABG) has emerged as a viable alternative to conventional sternotomy CABG in select patients requiring coronary revascularization. Specific techniques vary, but minimally invasive CABG (i.e., MIDCAB) usually involves revascularization of the left anterior descending (LAD) artery with the left internal mammary artery (LIMA)...
The 10 Commandments of Less Invasive CABG: How to Increase Adoption
Coronary artery bypass grafting (CABG) is one of the most performed operations worldwide. However, CABG is often as invasive today as it was 50 years ago...
Epicardial ultrasound in a case of myocardial bridge and apical hypertrophic cardiomyopathy
A 59-year-old male with a history of unstable angina was diagnosed with a myocardial bridge of the left anterior descending artery (LAD) and apical variant hypertrophic cardiomyopathy (AHCM). He underwent unroofing of the myocardial bridge and a left ventricular apical myectomy. Intraoperatively, epicardial ultrasound was used to identify the myocardial bridge with systolic compression of the LAD and confirm resolution of this compression postoperatively. Read more...
