Key result
Emergency coronary artery bypass grafting on a beating heart with a stabilizer during extracorporeal life support was successfully performed, resulting in normal ventricular function at 18 months.
Case Report (n=1)
No
Extracorporeal life support (ECLS) may be a useful strategy to facilitate emergency beating-heart CABG in pediatric patients with unstable hemodynamics.
May support ECLS-facilitated emergency beating-heart CABG in unstable pediatric cases; leaves open broader safety and applicability.
A 14-year old boy was admitted with an anomalous origin of the right coronary artery (RCA) from the left sinus of Valsalva, with an interarterial course of the narrow proximal segment. He underwent coronary ostial augmentation and main pulmonary artery translocation to the left pulmonary artery. In the post-cardiopulmonary bypass (CPB) period, he developed thrombotic occlusion of the RCA resulting in arrhythmia and ventricular dysfunction, requiring extracorporeal life support (ECLS) in the form of extracorporeal membrane oxygenation rather than CPB. After confirming this complication by cardiac catheterization, the right coronary artery territory was revascularized with a pedicled right internal thoracic artery graft. The entire procedure was performed on a beating heart using a stabilizer during ECLS. This strategy may be useful in situations with unstable haemodynamics and a low risk of blood loss.
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Panda et al. (2013) conducted a case report in Anomalous origin of the right coronary artery with post-CPB thrombotic occlusion (n=1). Extracorporeal life support (ECLS/ECMO) during emergency CABG was evaluated on Survival and graft patency. Emergency coronary artery bypass grafting on a beating heart with a stabilizer during extracorporeal life support was successfully performed, resulting in normal ventricular function at 18 months.
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