Calcified Ascending Aorta and Coronary Artery Disease

An elderly woman with severe coronary artery disease and calcified ascending and transverse aorta had a left internal thoracic artery graft to the first marginal branch of the circumflex artery and a right internal thoracic artery graft to the left anterior descending artery. It was performed using the “no-touch” technique to the ascending and transverse aorta, cardiopulmonary bypass with an arterial inflow to the left common femoral artery, a beating, warm, and vented heart, and bradycardia induced by a short-acting β1-blocker. The latter two were used to decrease myocardial oxygen consumption and facilitate construction of the internal thoracic artery to coronary artery anastomoses.