Revascularização cirúrgica miocárdica (RCM) na presença de aneurismas coronarianos

Abstract

This is the case of a patient with coronary aneurysms, who underwent CABG for surgical exclusion of these aneurysms, followed by implant of the bypass grafts to the arteries affected, with satisfactory short-term and long-term results.Coronary Artery Bypass Graft (CABG) right coronary artery (RCA), circumflex artery (Cx) and anterior interventricular artery (AIA) and dilation in the left coronary artery (LCA) extending to the AIA. Aneurysms in the initial portions of the right coronary artery and Cx were also found (Figure 1).Given these findings, the patient underwent CABG with cardiopulmonary bypass graft, mild hypothermia (32°C) and intermittent aortic clamping as myocardial protection method. The right coronary arteries, right marginal branch of the circumflex artery and AIA were grafted with autologous saphenous vein grafts. Aneurysms were excluded through the ligation of the proximal and distal stumps. The surgery and the postoperative period progressed with the patient, who showed good clinical and surgical parameters and was discharged on the 9 th day. Still in-hospital, the patient underwent hemodynamic restudy, which revealed the exclusion of aneurysms, patent aortocoronary grafts and maintenance of LV contractile function (Figure 2).