[A case of CABG under the cardiac arrest induced by a short acting beta-blocker without clamping the aorta].

Abstract

A seventy one year old woman had a coronary artery bypass grafting. No touch technique to her ascending aorta was applied due to the severely atherosclerotic aorta. Cardiac arrest was induced by a large dose of short acting beta-blocker (Esmolol) without cross-clamping the aorta under the normothermic cardio-pulmonary bypass. The heart was flaccid and rotated easily while the coronary anastomoses were performed. Both of the internal thoracic arteries were grafted individually to the anterior descending artery and to the circumflex artery. The cardiac beats were resumed with the ordinary inotropic support and then the cardio-pulmonary bypass was weaned off. Her postoperative course was uneventful and the cardiac enzyme level was not elevated. Both of the grafts were revealed patent by the postoperative angiography. Esmolol had played an important roll to perform excellent anastomoses and to protect the myocardium. It was concluded that this technique could be one of the suitable modality for patients with diseased aorta and further studies should be pursued concerning Esmolol as an alternative to the conventional cardioplegia.