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Alexander Kulik
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Hugh E. Scully
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Ann Thorac Surg 2004;78:313-314
© 2004 The Society of Thoracic Surgeons

Case report

Aortovenous bypass graft to the posterior left ventricle in absence of an identifiable coronary artery

Alexander Kulik, MDa, Michael A. Borger, MD, PhDa, Hugh E. Scully, MDa*

a Division of Cardiovascular Surgery, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada

Accepted for publication November 25, 2002.

* Address reprint requests to Dr Scully, Division of Cardiovascular Surgery, Toronto General Hospital, Eaton Bldg N-14-224, 200 Elizabeth St, Toronto, Ontario, Canada, M5G 2C4, USA
e-mail: hugh.scully{at}uhn.on.ca

We report the case of a 70-year-old woman with significant intermediate coronary artery stenosis who underwent a series of stent procedures, ultimately leading to compromise of the origin of the circumflex artery. Intraoperatively, identification of an obtuse marginal coronary artery was impossible due to a thick layer of epicardial fat, calcification of the posterior atrioventricular groove, and an adherent, thickened pericardium. Therefore, a saphenous vein graft to the posterior vein of the left ventricle was constructed with ligation of the vein cephalad. This uncommon approach to surgical revascularization effectively relieved the patient's angina and may be of use in other difficult cases.




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 Ann. Thorac. Surg.Home page
G. A. Kalweit, H. Huwer, S. El Dsoki, and H. Isringhaus
Late Complication of Aortocoronary Venous Bypass Grafting
Ann. Thorac. Surg., January 1, 2005; 79(1): e9 - e10.
[Abstract] [Full Text] [PDF]


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