EMERGENCY CORONARY REVASCULARIZATION USING POLYTETRAFLUOROETHYLENE CONDUITS IN A PATIENT IN CARDIOGENIC SHOCK

Summary: There is growing awareness that a particular subsct of patients with coronary artery disease who need surgical revascularization do not have autologous vein or internal mammary artery available or surgically applica- ble. The polytetrafluoroethylene graft has had limited use in aortocoronary bypass procedures. We describe a case of cardiogenic shock secondary to severe coronary artery disease and aortic stenosis, where the use of this synthet- ic graft contributed to a successful outcome. Angiographic patency was documented at 3 months follow-up. Our ex- perience, plus a review of the literature, supports the use of polytetrafluoroethylene grafts during aortocoronary ar- tery bypass to salvage infarcting or ischemic myocardi- um, when traditional autologous bypass conduits are not available or applicable. Key words: coronary surgery, polytetrafluorethylene, cardiogenic shock, emergency revascularization Introduction Aortocoronary bypass surgery traditionally has been per- formed with autologous saphenous vein or internal mam- mary artery. Today, the internal mammary artery is the preferred conduit, but the necessary additional time re- quired for dissection makes its use limited for patients in