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Successful CPR in a Patient with Left Main Coronary Stenosis and Severe Aortoilliac Disease Following Intubation

Received: 27 November 2016     Accepted: 9 December 2016     Published: 5 January 2017
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Abstract

The incidence of pre-bypass ischemia in patients undergoing coronary artery bypass grafting ranges between 10% to 50% [1]. We report in this paper a successful cardiopulmonary resuscitation (CPR) for a 75-year- old male patient with left main coronary disease who developed an asystolic cardiac arrest during induction, immediately after laryngoscopy and intubation. The arrest was managed by an immediate CPR and a prompt initiation of cardiopulmonary bypass. The patient had a very smooth and uneventful post operative course and was discharged from our institution 5 days after surgery without any organ damage. We discuss in this case report the factors that may have precipitated the arrest as well the elements -barbiturates, immediate CPR and tepid hypothermic bypass- that may have contributed to the excellent outcome.

Published in International Journal of Cardiovascular and Thoracic Surgery (Volume 2, Issue 4)
DOI 10.11648/j.ijcts.20160204.15
Page(s) 34-36
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2017. Published by Science Publishing Group

Keywords

Left Main Coronary Disease, Laryngoscopy, Cardiac Arrest, CPR, Tepid Hypothermic Bypass

References
[1] Kaplan J, Wynands J: Anesthesia for myocardial revascularization in Cardiac Anesthesia ed (4), WB Saunders company, 1999. pp 715.
[2] Kern M: Your patient has critical left main stenosis. Do you need an intra aortic balloon pump. Cath lab digest 16 (1), 2008.
[3] Sirian R, Wills J: Physiology of apnea and the benefits of preoxygenation. Continuing Education Anesthesia, Critical care and Pain 9 (4): 105-108, 2009.
[4] Tan PSK: The anesthetic management of circulatory arrest. Br J Hosp Med 43: 38, 1990.
[5] Thomas AN, Anderton JM, Harper NJN: Anesthesia for the treatment of a giant cerebral aneurysm under hypothermic circulatory arrest. Anesthesia 45: 383, 1990.
[6] Quasha AL, Tinker JH, Sharbrough FW: Hypothermia plus Thiopental: Prolonged encephalographic suppression. Anesthesiology 55: 636, 1981.
[7] Kamiya H, Kallenbach K, Halmer D et al: Surgey for aortic disease. Comparison of ascending aorta versus femoral artery cannulation for acute aortic dissection type A. Circulation 120: S282-S286, 2009.
[8] Van Arsdall GS, David TE, Butany J: Autopsy in acute type aortic dissection. Surgical implication. Circulation 98 (suppl): II-299-II-304, 1998.
[9] Holzer M: For the hypothermia after cardiac arrest study group. Mild therapeutic hypothermia to improve the neurologic outcome after cardiac arrest. NEng J Med 346: 549-556, 2002.
[10] Mijuskovic D, Stamenkovic DM, Borovic S et al: Successful resuscitation from two cardiac arrests in a female patient with critical aortic stenosis, severe mitral regurgitation and coronary artery disease. Vojnosanit Pregl 69 (8): 714-716, 2012.
[11] Fleisher A, Fleischmann KE, Auerbach AD et al: 2014 ACC/AHA guidelines on perioperative cardiovascular evaluation and management of patients undergoing non cardiac surgery. J Am Coll Cardiol 64 (22): 2373-2405, 2014.
Cite This Article
  • APA Style

    Nadine Kawkabani, Rula Darwish, Bassem Ayyache, Bassam Abu Khalil. (2017). Successful CPR in a Patient with Left Main Coronary Stenosis and Severe Aortoilliac Disease Following Intubation. International Journal of Cardiovascular and Thoracic Surgery, 2(4), 34-36. https://doi.org/10.11648/j.ijcts.20160204.15

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    ACS Style

    Nadine Kawkabani; Rula Darwish; Bassem Ayyache; Bassam Abu Khalil. Successful CPR in a Patient with Left Main Coronary Stenosis and Severe Aortoilliac Disease Following Intubation. Int. J. Cardiovasc. Thorac. Surg. 2017, 2(4), 34-36. doi: 10.11648/j.ijcts.20160204.15

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    AMA Style

    Nadine Kawkabani, Rula Darwish, Bassem Ayyache, Bassam Abu Khalil. Successful CPR in a Patient with Left Main Coronary Stenosis and Severe Aortoilliac Disease Following Intubation. Int J Cardiovasc Thorac Surg. 2017;2(4):34-36. doi: 10.11648/j.ijcts.20160204.15

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  • @article{10.11648/j.ijcts.20160204.15,
      author = {Nadine Kawkabani and Rula Darwish and Bassem Ayyache and Bassam Abu Khalil},
      title = {Successful CPR in a Patient with Left Main Coronary Stenosis and Severe Aortoilliac Disease Following Intubation},
      journal = {International Journal of Cardiovascular and Thoracic Surgery},
      volume = {2},
      number = {4},
      pages = {34-36},
      doi = {10.11648/j.ijcts.20160204.15},
      url = {https://doi.org/10.11648/j.ijcts.20160204.15},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcts.20160204.15},
      abstract = {The incidence of pre-bypass ischemia in patients undergoing coronary artery bypass grafting ranges between 10% to 50% [1]. We report in this paper a successful cardiopulmonary resuscitation (CPR) for a 75-year- old male patient with left main coronary disease who developed an asystolic cardiac arrest during induction, immediately after laryngoscopy and intubation. The arrest was managed by an immediate CPR and a prompt initiation of cardiopulmonary bypass. The patient had a very smooth and uneventful post operative course and was discharged from our institution 5 days after surgery without any organ damage. We discuss in this case report the factors that may have precipitated the arrest as well the elements -barbiturates, immediate CPR and tepid hypothermic bypass- that may have contributed to the excellent outcome.},
     year = {2017}
    }
    

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    AU  - Nadine Kawkabani
    AU  - Rula Darwish
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    AU  - Bassam Abu Khalil
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    JF  - International Journal of Cardiovascular and Thoracic Surgery
    JO  - International Journal of Cardiovascular and Thoracic Surgery
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    AB  - The incidence of pre-bypass ischemia in patients undergoing coronary artery bypass grafting ranges between 10% to 50% [1]. We report in this paper a successful cardiopulmonary resuscitation (CPR) for a 75-year- old male patient with left main coronary disease who developed an asystolic cardiac arrest during induction, immediately after laryngoscopy and intubation. The arrest was managed by an immediate CPR and a prompt initiation of cardiopulmonary bypass. The patient had a very smooth and uneventful post operative course and was discharged from our institution 5 days after surgery without any organ damage. We discuss in this case report the factors that may have precipitated the arrest as well the elements -barbiturates, immediate CPR and tepid hypothermic bypass- that may have contributed to the excellent outcome.
    VL  - 2
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Author Information
  • Department of Cardiac Surgery Anesthesia, St Georges Hospital University Medical Center, Beirut, Lebanon

  • Department of Cardiac Surgery Anesthesia, St Georges Hospital University Medical Center, Beirut, Lebanon

  • Department of Cardiothoracic Surgery, St Georges Hospital University Medical Center, University of Balamand, Beirut, Lebanon

  • Department of Cardiothoracic Surgery, St Georges Hospital University Medical Center, Beirut, Lebanon

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