A new technique of subcutaneous colon interposition

A colon interposition graft may be placed in the subcutaneous position when other routes are not available. Creation of an adequate subcutaneous tunnel may be difficult, especially in patients with prior sternotomy. In this report we describe a method that utilizes tissue expanders to facilitate subcutaneous esophageal reconstruction.     

Neurological monitoring and off-pump surgery in a very high-risk stroke patient

Stroke remains a high risk of coronary artery bypass grafting. We present a patient with progressively symptomatic coronary disease and severe four-vessel cerebrovascular disease not amenable to revascularization. This patient underwent coronary revascularization without neurologic complication using off-pump coronary surgery to avoid aortic manipulation and intraoperative electroencephalographic monitoring of cerebral perfusion. This management strategy may reduce the stroke risk in similar patients.