Case Report
Copyright ©2014 Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 16, 2014; 2(9): 466-468
Published online Sep 16, 2014. doi: 10.12998/wjcc.v2.i9.466
Coronary artery bypass graft surgery in a patient with ureterosigmoidostomy
Ismail Haberal, Deniz Ozsoy, Ege Sipahi, Murat Mert
Ismail Haberal, Deniz Ozsoy, Ege Sipahi, Murat Mert, Department of Cardiovasculary Surgery, Cardiology Institute, Istanbul University, 34116 Istanbul, Turkey
Author contributions: Haberal I, Ozsoy D and Mert M designed the report; Sipahi E collected the patient’s clinical data; Haberal I and Ozsoy D analyzed the data and wrote the paper.
Correspondence to: Ismail Haberal, MD, Department of Cardiovasculary Surgery, Cardiology Institute, Istanbul University, Semsettin Gunaltay cad. Bengi sok. Derya Apt. No:12 D:34 Erenkoy, Kadikoy, 34116 Istanbul, Turkey. doktorhaberal@hotmail.com
Telephone: +90-216-3868252
Received: March 13, 2014
Revised: April 25, 2014
Accepted: July 12, 2014
Published online: September 16, 2014
Abstract

A 75-year-old male patient had stable angina pectoris. After coronary angiography we decided to perform a coronary artery bypass graft surgery. Twenty years ago the patient underwent radical cystectomy and bilateral ureterosigmoidostomy because of bladder cancer. After that, his micturition was via the rectum. We did not experience that before. As is known, monitoring of urine output is very important after cardiac surgery. The patient was consulted with an urologist for how to monitor urine output in him. Transrectal catheterization was recommended for our follow-up, but before the catheterization bowel cleansing is necessary. Four-vessel on-pump coronary artery bypass graft surgery was performed without any problem. Peroperative urine volume and arterial blood gas results were normal. Urine output is a sensitive variable reflecting the patient’s effective blood volume and tissue perfusion. Urinary catheterization is a standard for all cardiac surgeries, and it allows the patients’ urine to drain freely from the bladder for collection. Monitoring of urine output in patients with ureterosigmoidostomy is impossible by standard urinary catheterization method. In this case we performed transrectal catheterization for Urine flow follow-up. Urine flow follow-up is essential after the open-heart surgery and it can be measured in different ways, as in our case.

Keywords: Open heart surgery, Urine output follow-up, Catheterization, Ureterosigmoidostomy, Coronary artery bypass graft

Core tip: With this case, we had experience that we can monitor urine output in different ways rather than urethral catheterization such as catheterization in a transrectal way that we had to do in a patient who had ureterosigmoidostomy.