RESUMEN
The use of the internal mammary artery for coronary artery bypass grafting is common. We describe a patient with chronic renal insufficiency who had no need for dialysis, and who suffered from breast necrosis after coronary artery bypass grafting with internal mammary artery harvesting due to calciphylaxis. The histology report of the breast tissue showed mural vascular calcification and intima proliferation of small-sized to medium-sized vessels. This causes ischemic necrosis of the skin and septal panniculitis. We believe that this is the first case report of breast necrosis after coronary artery bypass grafting, due to calciphylaxis in a patient with known chronic renal insufficiency, without renal replacement therapy.
Asunto(s)
Mama/irrigación sanguínea , Calcifilaxia/etiología , Estenosis Coronaria/cirugía , Infarto/etiología , Anastomosis Interna Mamario-Coronaria/efectos adversos , Anciano de 80 o más Años , Biopsia con Aguja , Mama/patología , Mama/cirugía , Calcifilaxia/patología , Calcifilaxia/cirugía , Puente de Arteria Coronaria/efectos adversos , Puente de Arteria Coronaria/métodos , Estenosis Coronaria/complicaciones , Estenosis Coronaria/diagnóstico , Desbridamiento/métodos , Progresión de la Enfermedad , Resultado Fatal , Femenino , Humanos , Inmunohistoquímica , Infarto/patología , Infarto/cirugía , Anastomosis Interna Mamario-Coronaria/métodos , Fallo Renal Crónico/complicaciones , Fallo Renal Crónico/diagnóstico , Necrosis/patología , Necrosis/cirugía , Obesidad/complicaciones , Obesidad/diagnóstico , Enfermedades Raras , Índice de Severidad de la EnfermedadRESUMEN
Chronic thrombosis of the Carpentier-Edwards SAV porcine aortic bioprosthesis is a very rare complication.We present the case of an 80-year-old male patient with dyspnoea NYHA class III 30 months after coronary artery bypass grafting and aortic valve replacement. Echocardiography showed an increased gradient over the bioprosthesis and blockage of the right coronary leaflet. Reoperation revealed a large thrombotic deposition on the right and non-coronary leaflets. To the best of our knowledge this is only the second case reported in the literature.
Asunto(s)
Bioprótesis , Trombosis Coronaria/etiología , Trombosis Coronaria/cirugía , Prótesis Valvulares Cardíacas/efectos adversos , Anciano de 80 o más Años , Animales , Estenosis de la Válvula Aórtica/cirugía , Procedimientos Quirúrgicos Cardiovasculares , Puente de Arteria Coronaria/efectos adversos , Trombosis Coronaria/diagnóstico por imagen , Disnea/etiología , Humanos , Masculino , Falla de Prótesis , Reoperación , Porcinos , Resultado del Tratamiento , UltrasonografíaRESUMEN
It is not obvious to visualize and expose the main trunk of the pulmonary artery through a port access approach. We describe surgical and anesthesiology measures necessary to perform the removal of an atrial septal defect closure device safely and adequately.
