Myocardial Revascularisation in Calcified Aorta in CKD Patient with Help of ENCLOSEII Device, A Bail Out Situation

Abstract

In this case, a 56 years dialysis dependent patient presented with complaints of angina at rest for 2 weeks after which she was thoroughly evaluated and was diagnosed with coronary artery disease with calcified aorta along with calcification of other vessels also, following which she was planned for CABG surgery. The unclampable ascending aorta (UAA) is a condition increasingly encountered during CABG procedures[1]. Aging of the population and the increase in patients on dialysis have led to an increasing frequency of “porcelain aorta”[2]. The use of the no-touch technique is associated with a high perioperative risk but a superior possibility of complete revascularisation, whereas the adoption of the no-pump strategy ensures a smoother postoperative course at the expense of a higher incidence of ischemia recurrence[3]. Enclose-II anastomosis assist device was originally developed as an ancillary device for proximal anastomosis in off-pump coronary artery bypass grafting (OPCABG), to assist anastomosis for the vascular grafts without clamping the ascending aorta[3]