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[Combined revascularization of coronary and femoral arteries]
K Tsuchiya1, M Yoshikai, J Kato
1Department of Cardiovascular Surgery, Yamanashi Prefectural Hospital.
Insights
A combined surgical procedure successfully treated a patient with coronary artery disease and leg ischemia. This approach restored blood flow, alleviating symptoms of both conditions.
Area of Science:
- Cardiovascular Surgery
- Vascular Surgery
Background:
- Coronary artery disease (CAD) and peripheral artery disease (PAD), specifically leg ischemia, often coexist.
- Managing patients with both CAD and PAD presents complex surgical challenges.
Observation:
- A 63-year-old male patient presented with symptomatic CAD and bilateral leg ischemia.
- The patient underwent a complex combined surgical intervention.
Findings:
- Coronary arteries were bypassed using saphenous vein graft and left internal mammary artery.
- Bilateral femoral arteries were reconstructed with expanded polytetrafluoroethylene grafts originating from the ascending aorta.
- The surgical approach involved a preperitoneal abdominal wall tunnel for graft passage.
Implications:
- This combined procedure effectively resolved angina and claudication in the patient.
- It highlights a viable surgical strategy for managing multivessel coronary and severe peripheral arterial disease.
- Successful simultaneous revascularization can significantly improve quality of life for patients with complex atherosclerotic disease.
Abstract:
A 63-year-old male patient with both coronary artery disease and leg ischemia was successfully treated with a combined procedure. Coronary arteries were bypassed with the saphenous vein graft and in situ left internal mammary artery, and bilateral femoral arteries were bypassed with expanded polytetrafluoroethylene grafts descended from the ascending aorta through the preperitoneal abdominal wall tunnel. After this procedure he experienced neither angina nor claudication.