A trial case of coronary bypass surgery under heart beat in a patient with severe functional disorders of kidney

Coronary artery bypass grafting (CABG) was performed under heart beat without conducting extracorporeal circulation in a patient with severe functional disorders of kidney, and satisfactory results were attained. The patient was a 71-year-old male with past history of severe functional disorders of kidney and cerebral infarction. He had triple-vessel disease. First, CABG was performed for the primary branches under heart beat without adopting extra-corporeal circulation, then later, percutaneous transluminal coronary angioplasty (PTCA) was performed for the residual lesions, which lead to complete revascularization without causing aggravation of cerebral infarction or functional disorders of kidney or subjective symptoms such as chest pain. CABG conducted under heart beat is less aggressive not only to myocardium but to other important organs, and is thought to be effective for patients who have severe concurrent diseases to which extracorporeal circulation is likely to entail risks. Furthermore, concurrent therapy with PTCA is thought to expand the scope of application of CABG under heart beat including the cases of multiple-vessel diseases.