Perioperative complications
In 2 patients (2.9%), a coronary bypass surgery was required as a result of intraoperative (n = 1) or postoperative (n = 1) myocardial ischaemia. In 1 patient, a single coronary artery bypass graft to the right coronary artery was performed as preoperatively intended due to coronary artery anomaly.
Intraoperative ischaemia was suspected in 1 patient due to ECG changes and right ventricular dysfunction during weaning from cardiopulmonary bypass (CBP). The patient received a venous aorto-coronary bypass graft to the right coronary artery in the first segment and had an uneventful recovery after the operation.
One other patient showed a progressive increase in cardiac enzymes and ECG changes during the first postoperative day. An urgent coronary angiography revealed a stenosis of the common trunk of the left coronary artery, which was difficult to prepare and reimplant following a previous aortic valve-sparing procedure. The left internal mammary artery on left anterior descending artery and a venous graft on a postero-lateral branch were used as left coronary artery bypasses for myocardial revascularization. The patient's subsequent course was uneventful and he was discharged on the 12th postoperative day.
In the third patient with truncus arteriosus communis type I and origin anomalies of both coronary arteries, a venous aorto-coronary bypass to the proximal right coronary artery was performed before CBP weaning due to poor right ventricular contractility, the further intra- and postoperative course was uneventful.