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Simultaneous abdominal aortic aneurysm repair during the on-pump coronary artery bypass grafting

Hiroshi Ohuchi1, Satoshi Gojo, Hiroshige Sato

  • 1Department of Cardiovascular Surgery, Saitama Medical Center, Saitama Medical School, Satitama, Japan.

Annals of Thoracic and Cardiovascular Surgery : Official Journal of the Association of Thoracic and Cardiovascular Surgeons of Asia
|March 9, 2004
PubMed

Insights

Simultaneous coronary artery bypass grafting (CABG) and abdominal aortic aneurysm (AAA) repair using cardiopulmonary bypass (CPB) is feasible. This combined approach reduces operation time and aids cardiac management during AAA repair.

Area of Science:

  • Cardiovascular Surgery
  • Thoracic and Cardiovascular Surgery

Background:

  • Left main coronary disease and infrarenal abdominal aortic aneurysm (AAA) often coexist in elderly patients.
  • Surgical management of both conditions presents significant challenges due to patient comorbidities and procedural complexity.

Observation:

  • A 74-year-old male patient with both left main coronary disease and infrarenal AAA underwent simultaneous coronary artery bypass grafting (CABG) and AAA repair.
  • The procedures were performed concurrently by separate surgical teams utilizing cardiopulmonary bypass (CPB).

Findings:

  • The combined surgery involved triple CABG and infrarenal AAA repair, with CPB, aortic clamp, and total operation times of 81, 33, and 245 minutes, respectively.
  • The patient experienced an uneventful postoperative recovery, being extubated within three hours of ICU admission.

Implications:

  • Simultaneous CABG and AAA repair on CPB offers potential benefits, including reduced overall operation time and improved blood salvage.
  • Utilizing CPB facilitates better management of cardiac preload and afterload, crucial for protecting the heart during AAA repair.

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