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Simultaneous surgery for ischemic heart disease, type A aortic dissection and abdominal aneurysm
H Sakamoto1, I Fukuda, J Seita
1Department of Cardiovascular Surgery, Tsukuba Medical Center Hospital, Tsukuba, Japan.
Insights
This study reports a complex simultaneous surgical approach for a 72-year-old male with severe coronary artery disease and multiple aortic aneurysms. The patient successfully underwent combined procedures, demonstrating a safe and effective treatment strategy.
Area of Science:
- Cardiovascular Surgery
- Aortic Surgery
- Coronary Artery Bypass Grafting
Background:
- The patient presented with three-vessel coronary artery disease, chronic dissecting aneurysm of the ascending aorta with moderate aortic regurgitation, and a large abdominal aortic aneurysm (7 cm).
- Staged surgical interventions were deemed high-risk due to the complexity and extent of the patient's cardiovascular pathology.
Observation:
- A simultaneous, multi-component surgical strategy was employed to address all major cardiovascular issues concurrently.
- The procedures included double coronary artery bypass, aortic root remodeling, ascending aorta replacement with a tube graft, and abdominal aortic aneurysm repair with a Y-graft.
Findings:
- The patient experienced a complete recovery following the complex simultaneous surgical procedures.
- No serious complications were observed post-operatively, indicating successful management of extensive cardiovascular disease.
Implications:
- Simultaneous surgical correction of combined coronary artery disease and extensive aortic aneurysms is feasible and can lead to favorable outcomes.
- This approach may offer a viable alternative to staged procedures in select high-risk patients, potentially reducing overall treatment risk and duration.
Abstract:
The patient was a 72-year-old male with three-vessel coronary artery disease, chronic dissecting aneurysm of the ascending aorta with moderate aortic regurgitation, and abdominal aortic aneurysm 7 cm in diameter. Because staged procedure seemed to exacerbate the risk due to the remaining lesion, simultaneous procedures (double coronary artery bypass, aortic root remodeling, tube replacement of the ascending aorta and Y-graft replacement of the abdominal aneurysm) were performed. The patient recovered completely without any serious complication.