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Beating Heart Aortic Valve Replacement After Previous Coronary Artery Bypass Surgery With a Patent Internal Mammary Artery Graft Roberto Battellini, MD, Ardawan Julian Rastan, MD, Alexander Fabricius, MD, Martin Moscoso-Luduena, MD, Nicole Lachmann, MD, Friedrich Wilhelm Mohr, MD, PhD The Annals of Thoracic Surgery Volume 83, Issue 3, Pages (March 2007) DOI: /j.athoracsur Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions
Fig 1 On-pump beating heart aortic valve replacement using simultaneous antegrade-retrograde coronary perfusion of oxygenated blood. (a) Occlusion of the left main coronary artery (LCA) and significant stenosis of the right coronary artery (RCA) required perfusion through a new venous RCA bypass (arrow). Three occluded venous grafts were present. (b) Functioning venous grafts were distal to the aortic clamp. Coronary backflow was controlled by a Fogarty catheter in the LCA and a vessel loop around the RCA (arrow). (c) Functioning venous grafts were below the level of the clamp. Bypass perfusion was made through a hood incision of the sequential graft using a separate blood line (arrow). The Annals of Thoracic Surgery , DOI: ( /j.athoracsur ) Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions
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