We report the case of a 70-year-old man who underwent off-pump coronary artery bypass grafting 15-years after left pneumonectomy. He had significant two-vessel coronary artery disease. Comorbidities included poor ventricular function and impaired respiratory function. Operative risks in this clinical setting is increased. Our patient underwent off-pump CABG × 2. Thoracic epidural analgesia was also used to facilitate post-operative recovery. The patient was extubated an hour after the end of the procedure. The role of off-pump surgery in this high-risk population and the use of stabilizing devices in these extreme anatomical situations is discussed.
AbrahamR.KaramanoukianH. L.JajkowskiM. R.Low ejection fraction is not a contraindication to off-pump coronary artery surgery. Heart Surg Forum, 2001, 4(2), 141–146.
3.
KoutlasT. C.ElbeeryJ. R.WilliamsJ. M.Myocardial revascularisation in the elderly using beating heart coronary artery bypass surgery. Ann Thorac Surg, 2000, 69(4), 1042–1047.
4.
CoxC. M.AscioneR.CohenA. M.Effect of cardiopulmonary bypass on pulmonary gas exchange: a prospective randomized study. Ann Thorac Surg, 2000, 69(1), 140–145.
5.
JoachimssonP. O.NystromS. O.TydenH.Early extubation after coronary artery surgery in efficiently rewarmed patients: a postoperative comparison of opioid anaesthesia versus inhalational anaesthesia and thoracic epidural analgesia. J Cardiothorac Anaesth, 1989, 3, 344–353.
