Graftmaster savior: Injury to a patent LIMA during pericardiectomy, when a covered stent came to the rescue

Stephen O. Awuor, Steven Ettinger, Louis M. Capecci, Walter Pae

Research output: Contribution to journalArticle

Abstract

A 71-year-old male with multivessel coronary artery disease who underwent bypass with saphenous vein grafts to a Marginal branch and distal RCA and LIMA to LAD in 1988, DM II, atrial fibrillation on Coumadin, TIA, obstructive sleep apnea and pulmonary hypertension was referred to our institution after extensive dyspnea evaluation with a diagnosis of constrictive pericarditis for pericardiectomy. He had normal left ventricular function, moderate mitral and tricuspid regurgitation. Coronary angiography revealed ostial LAD CTO, patent LIMA to mid LAD, second Marginal branch CTO with left-to-left collaterals and mid RCA CTO with left-to-right collaterals. Vein grafts to the Marginal branch and distal RCA were occluded. The pericardium was heavily calcified on CT of the chest. The LIMA was inadvertently injured leading to acute STEMI and ventricular fibrillation arrest treated with defibrillation once. Surgical repair was unsuccessful. A Graftmaster covered stent was successful deployed with restoration of TIMI III flow to the LAD territory. Pericardiectomy was completed via both the median resternotomy and left thoracotomy. Triple therapy with Aspirin, Clopidogrel, and Coumadin was initiated and maintained for 3 months without hemorrhagic or thrombotic complications. He has continued to do well in follow-up on Clopidogrel and Coumadin.

Original languageEnglish (US)
Pages (from-to)E326-E330
JournalCatheterization and Cardiovascular Interventions
Volume93
Issue number6
DOIs
StatePublished - May 1 2019

Fingerprint

clopidogrel
Pericardiectomy
Warfarin
Stents
Wounds and Injuries
Constrictive Pericarditis
Transplants
Tricuspid Valve Insufficiency
Pericardium
Saphenous Vein
Mitral Valve Insufficiency
Ventricular Fibrillation
Obstructive Sleep Apnea
Thoracotomy
Coronary Angiography
Left Ventricular Function
Pulmonary Hypertension
Dyspnea
Atrial Fibrillation
Aspirin

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

@article{c2d298f953e14099856b9e63cbd67319,
title = "Graftmaster savior: Injury to a patent LIMA during pericardiectomy, when a covered stent came to the rescue",
abstract = "A 71-year-old male with multivessel coronary artery disease who underwent bypass with saphenous vein grafts to a Marginal branch and distal RCA and LIMA to LAD in 1988, DM II, atrial fibrillation on Coumadin, TIA, obstructive sleep apnea and pulmonary hypertension was referred to our institution after extensive dyspnea evaluation with a diagnosis of constrictive pericarditis for pericardiectomy. He had normal left ventricular function, moderate mitral and tricuspid regurgitation. Coronary angiography revealed ostial LAD CTO, patent LIMA to mid LAD, second Marginal branch CTO with left-to-left collaterals and mid RCA CTO with left-to-right collaterals. Vein grafts to the Marginal branch and distal RCA were occluded. The pericardium was heavily calcified on CT of the chest. The LIMA was inadvertently injured leading to acute STEMI and ventricular fibrillation arrest treated with defibrillation once. Surgical repair was unsuccessful. A Graftmaster covered stent was successful deployed with restoration of TIMI III flow to the LAD territory. Pericardiectomy was completed via both the median resternotomy and left thoracotomy. Triple therapy with Aspirin, Clopidogrel, and Coumadin was initiated and maintained for 3 months without hemorrhagic or thrombotic complications. He has continued to do well in follow-up on Clopidogrel and Coumadin.",
author = "Awuor, {Stephen O.} and Steven Ettinger and Capecci, {Louis M.} and Walter Pae",
year = "2019",
month = "5",
day = "1",
doi = "10.1002/ccd.28100",
language = "English (US)",
volume = "93",
pages = "E326--E330",
journal = "Catheterization and Cardiovascular Interventions",
issn = "1522-1946",
publisher = "Wiley-Liss Inc.",
number = "6",

}

Graftmaster savior : Injury to a patent LIMA during pericardiectomy, when a covered stent came to the rescue. / Awuor, Stephen O.; Ettinger, Steven; Capecci, Louis M.; Pae, Walter.

In: Catheterization and Cardiovascular Interventions, Vol. 93, No. 6, 01.05.2019, p. E326-E330.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Graftmaster savior

T2 - Injury to a patent LIMA during pericardiectomy, when a covered stent came to the rescue

AU - Awuor, Stephen O.

AU - Ettinger, Steven

AU - Capecci, Louis M.

AU - Pae, Walter

PY - 2019/5/1

Y1 - 2019/5/1

N2 - A 71-year-old male with multivessel coronary artery disease who underwent bypass with saphenous vein grafts to a Marginal branch and distal RCA and LIMA to LAD in 1988, DM II, atrial fibrillation on Coumadin, TIA, obstructive sleep apnea and pulmonary hypertension was referred to our institution after extensive dyspnea evaluation with a diagnosis of constrictive pericarditis for pericardiectomy. He had normal left ventricular function, moderate mitral and tricuspid regurgitation. Coronary angiography revealed ostial LAD CTO, patent LIMA to mid LAD, second Marginal branch CTO with left-to-left collaterals and mid RCA CTO with left-to-right collaterals. Vein grafts to the Marginal branch and distal RCA were occluded. The pericardium was heavily calcified on CT of the chest. The LIMA was inadvertently injured leading to acute STEMI and ventricular fibrillation arrest treated with defibrillation once. Surgical repair was unsuccessful. A Graftmaster covered stent was successful deployed with restoration of TIMI III flow to the LAD territory. Pericardiectomy was completed via both the median resternotomy and left thoracotomy. Triple therapy with Aspirin, Clopidogrel, and Coumadin was initiated and maintained for 3 months without hemorrhagic or thrombotic complications. He has continued to do well in follow-up on Clopidogrel and Coumadin.

AB - A 71-year-old male with multivessel coronary artery disease who underwent bypass with saphenous vein grafts to a Marginal branch and distal RCA and LIMA to LAD in 1988, DM II, atrial fibrillation on Coumadin, TIA, obstructive sleep apnea and pulmonary hypertension was referred to our institution after extensive dyspnea evaluation with a diagnosis of constrictive pericarditis for pericardiectomy. He had normal left ventricular function, moderate mitral and tricuspid regurgitation. Coronary angiography revealed ostial LAD CTO, patent LIMA to mid LAD, second Marginal branch CTO with left-to-left collaterals and mid RCA CTO with left-to-right collaterals. Vein grafts to the Marginal branch and distal RCA were occluded. The pericardium was heavily calcified on CT of the chest. The LIMA was inadvertently injured leading to acute STEMI and ventricular fibrillation arrest treated with defibrillation once. Surgical repair was unsuccessful. A Graftmaster covered stent was successful deployed with restoration of TIMI III flow to the LAD territory. Pericardiectomy was completed via both the median resternotomy and left thoracotomy. Triple therapy with Aspirin, Clopidogrel, and Coumadin was initiated and maintained for 3 months without hemorrhagic or thrombotic complications. He has continued to do well in follow-up on Clopidogrel and Coumadin.

UR - http://www.scopus.com/inward/record.url?scp=85060905503&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85060905503&partnerID=8YFLogxK

U2 - 10.1002/ccd.28100

DO - 10.1002/ccd.28100

M3 - Article

C2 - 30690858

AN - SCOPUS:85060905503

VL - 93

SP - E326-E330

JO - Catheterization and Cardiovascular Interventions

JF - Catheterization and Cardiovascular Interventions

SN - 1522-1946

IS - 6

ER -