Combined minimally invasive procedure for descending thoracic aortic aneurysm with left main coronary artery disease

Area of Science:

• Cardiovascular Surgery
• Vascular Surgery
• Interventional Cardiology

Background:

• Patients with descending thoracic aortic aneurysms often have concomitant coronary artery disease, necessitating complex treatment strategies.
• Traditional surgical approaches may involve significant morbidity due to cardiopulmonary bypass and extensive incisions.

Observation:

• A 78-year-old male patient presented with a descending thoracic aortic aneurysm and severe left main coronary artery disease.
• The patient underwent a combined beating heart coronary artery bypass grafting and endovascular thoracic aortic aneurysm repair without cardiopulmonary bypass.

Findings:

• Coronary artery bypass grafting was successfully performed on the left anterior descending artery and obtuse marginal branch via a small left anterolateral thoracotomy.
• Thoracic aortic aneurysm exclusion was achieved using stent grafts inserted through a small femoral incision.

Implications:

• This combined, minimally invasive strategy offers a promising alternative for patients with concurrent thoracic aortic aneurysms and coronary artery disease.
• Avoiding cardiopulmonary bypass may lead to reduced surgical trauma and potentially faster recovery times.
• This approach highlights the feasibility of hybrid procedures for complex cardiovascular pathology.