A novel technique for pulmonary endarterectomy in the presence of patent coronary artery bypass grafts

Abstract

Pulmonary endarterectomy (PEA) is the definitive surgical treatment for chronic thromboembolic pulmonary hypertension, with excellent short- and long-term results. PEA following previous coronary artery bypass graft surgery carries a risk of damage to patent grafts, as well as the risk of inadequate myocardial protection, especially when a patent pedicled internal thoracic artery graft is present. We report a technique where PEA may be safely and successfully accomplished ensuring, adequate clearance of bilateral pulmonary thromboembolic disease via a right pulmonary arteriotomy, avoiding the patent bypass grafts overlying the pulmonary trunk, while ensuring adequate myocardial protection.