Technical considerations for coronary artery bypass without cardioplegia. 1992

L I Bonchek
Department of Cardiothoracic Surgery, Lancaster General Hospital, Pennsylvania.

Coronary artery bypass without cardioplegia remains the preferred technique at many centers around the world. This report describes in detail a technique that emphasizes intermittent cross-clamping of the aorta at mild hypothermia (30 degrees C). Since coronary bypass procedures require brief interruptions of coronary blood flow only for the distal anastomoses, the duration of myocardial ischemia with this technique is not prolonged by unexpected changes in the operative plan. Many bypass grafts can also be carried out without cross-clamping of the aorta by using local control of the coronary arteries. The increasing number of elderly patients with atherosclerotic aortas that cannot be safely clamped makes it helpful for all cardiac surgeons to be familiar with noncardioplegic techniques.

UI MeSH Term Description Entries
D007036 Hypothermia, Induced Abnormally low BODY TEMPERATURE that is intentionally induced in warm-blooded animals by artificial means. In humans, mild or moderate hypothermia has been used to reduce tissue damages, particularly after cardiac or spinal cord injuries and during subsequent surgeries. Induced Hypothermia,Mild Hypothermia, Induced,Moderate Hypothermia, Induced,Targeted Temperature Management,Therapeutic Hypothermia,Hypothermia, Therapeutic,Induced Mild Hypothermia,Induced Mild Hypothermias,Induced Moderate Hypothermia,Induced Moderate Hypothermias,Mild Hypothermias, Induced,Moderate Hypothermias, Induced,Targeted Temperature Managements
D007431 Intraoperative Complications Complications that affect patients during surgery. They may or may not be associated with the disease for which the surgery is done, or within the same surgical procedure. Peroperative Complications,Surgical Injuries,Complication, Intraoperative,Complication, Peroperative,Injuries, Surgical,Complications, Intraoperative,Complications, Peroperative,Injury, Surgical,Intraoperative Complication,Peroperative Complication,Surgical Injury
D012086 Reoperation A repeat operation for the same condition in the same patient due to disease progression or recurrence, or as followup to failed previous surgery. Revision, Joint,Revision, Surgical,Surgery, Repeat,Surgical Revision,Repeat Surgery,Revision Surgery,Joint Revision,Revision Surgeries,Surgery, Revision
D003250 Constriction The act of constricting. Clamping,Clampings,Constrictions
D006324 Heart Arrest, Induced A procedure to stop the contraction of MYOCARDIUM during HEART SURGERY. It is usually achieved with the use of chemicals (CARDIOPLEGIC SOLUTIONS) or cold temperature (such as chilled perfusate). Cardiac Arrest, Induced,Cardioplegia,Induced Cardiac Arrest,Induced Heart Arrest,Cardioplegias
D006350 Heart Valve Prosthesis A device that substitutes for a heart valve. It may be composed of biological material (BIOPROSTHESIS) and/or synthetic material. Prosthesis, Heart Valve,Cardiac Valve Prosthesis,Cardiac Valve Prostheses,Heart Valve Prostheses,Prostheses, Cardiac Valve,Prostheses, Heart Valve,Prosthesis, Cardiac Valve,Valve Prostheses, Cardiac,Valve Prostheses, Heart,Valve Prosthesis, Cardiac,Valve Prosthesis, Heart
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001011 Aorta The main trunk of the systemic arteries. Aortas
D001018 Aortic Diseases Pathological processes involving any part of the AORTA. Aortic Disease,Disease, Aortic,Diseases, Aortic
D001022 Aortic Valve Insufficiency Pathological condition characterized by the backflow of blood from the ASCENDING AORTA back into the LEFT VENTRICLE, leading to regurgitation. It is caused by diseases of the AORTIC VALVE or its surrounding tissue (aortic root). Aortic Incompetence,Aortic Regurgitation,Aortic Valve Incompetence,Regurgitation, Aortic Valve,Incompetence, Aortic,Incompetence, Aortic Valve,Insufficiency, Aortic Valve,Regurgitation, Aortic

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