Off-Pump Coronary Artery Bypass and Ascending Aorta-to-Left Carotid Artery Bypass with a Median Sternotomy Incision

A 70-year-old male patient complaining of dizziness, shortness of breath, and chest pa- in was admitted to the our hospital. Coronary angiography showed severe stenosis in the left ante- rior descending artery, right descending coronary artery and circumflex coronary artery. In the routine preoperative examination, severe proximal common carotid artery stenosis was detected on the computerized tomography. A median sternotomi was performed under general anesthesia. Ascending aorta-to-left carotid artery bypass was done with a 6-mm polytetrafluoroethylene graft, and left internal mammarian artery-left anterior desending artery, aorta-saphenous vein-right co- ronary artery bypass graftings were performed with off-pump technique. We suppose that a medi- an sternotomy is beneficial and since it does not require an additional incision and the low risk of wound infection in proximal carotid stenosis.