[Coronary revascularization using profound hypothermia with elective ventricular fibrillation and total circulatory arrest].

ABSTRACT

Profound hypothermia with elective ventricular fibrillation and total circulatory arrest was used in a patient undergoing coronary artery bypass grafting (CABG) with severe calcification of the ascending aorta. A 76-year-old woman with unstable angina was referred for coronary revascularization. Ascending aorta was severely calcified with the exception of limited region of proximal ascending aorta, and the coronary arteriography showed high-grade obstruction of the left anterior descending (LAD) and dominant right coronary artery (RCA). The left internal thoracic artery was anastomosed to the LAD, and the saphenous vein graft to the RCA under systemic moderate hypothermia and elective ventricular fibrillation. During the proximal anastomosis of the saphenous vein graft to the non-calcified ascending aorta, profound hypothermia and circulatory arrest was instituted for 11 minutes. The wean from extracorporeal circulation was successful, and the postoperative course was uneventful.