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Published on: September 15, 2023
Simultaneous operation of off pump coronary artery bypass and abdominal aortic aneurysm repair
Hiroya Minami1, Nobuhiko Mukohara, Hidefumi Obo
1Department of Cardiovascular Surgery, Himeji Cardiovascular Center, Himeji, Hyogo, Japan.
Insights
Simultaneous repair of abdominal aortic aneurysms (AAA) and off-pump coronary artery bypass (OPCAB) surgery is safe. This combined procedure offers comparable morbidity and mortality rates to individual treatments for coronary artery disease and AAA.
Area of Science:
- Cardiovascular Surgery
- Vascular Surgery
- Cardiac Surgery
Background:
- Coronary artery disease (CAD) and abdominal aortic aneurysms (AAA) frequently coexist, posing treatment challenges.
- Managing these conditions independently can complicate the care pathway for each disease.
Purpose of the Study:
- To evaluate the safety and acceptability of performing simultaneous AAA repair and off-pump coronary artery bypass (OPCAB) surgery.
- To compare the outcomes of combined AAA repair and OPCAB with those of each procedure performed alone.
Main Methods:
- Retrospective review of patients undergoing simultaneous AAA repair and OPCAB (n=18) from June 1999 to December 2003.
- Comparison with patients who underwent AAA repair alone (n=239) and OPCAB alone (n=137).
- Analysis of patient demographics, aneurysm size, ejection fraction, operative details, and clinical outcomes.
Main Results:
- The simultaneous AAA/OPCAB group had significantly longer operative times, greater blood loss, and higher transfusion requirements compared to AAA alone.
- AAA/OPCAB patients experienced longer hospital stays than AAA alone but comparable to OPCAB alone.
- No significant differences in morbidity and mortality rates were observed among the three groups (AAA/OPCAB, AAA alone, OPCAB alone).
Conclusions:
- Simultaneous AAA repair and OPCAB can be safely performed.
- The combined procedure demonstrates similar morbidity and mortality rates to independent surgical interventions for CAD and AAA.
Objectives:
Coronary artery disease (CAD) and abdominal aortic aneurysms (AAA) commonly coexist. However, each disease treatment complicates the management of the other. In this study, we evaluate whether a simultaneous operation of AAA repair and off pump coronary artery bypass (OPCAB) would be safe and acceptable, compared with either procedure alone.
Subjects And Methods:
We retrospectively reviewed all patients who underwent simultaneous AAA repair and OPCAB (AAA/OPCAB, n=18), compared AAA repair alone (AAA, n=239) and OPCAB alone (OPCAB, n=137) from June 1999 to December 2003. There were no significant differences with regard to age or gender, but the AAA/OPCAB group had significantly larger aneurysms (60.6 vs. 53.2 mm) and significantly lower ejection fractions (EF) (54.9 vs. 60.3%).
Results:
The patients in the AAA/OPCAB group underwent a significantly longer operative time than AAA, OPCAB (403 vs. 360, 296 minutes, respectively), there was significantly greater blood loss (726 vs. 426, 462 ml), and more transfusion required (8.13 vs. 1.69, 2.8 units). The number of bypass grafts in AAA/OPCAB group (1-5 per patients) was significantly smaller (1.78 vs. 2.93). The AAA/OPCAB patients had a significantly longer hospital stay than the AAA (38 vs. 22 days), but was not significantly longer than the OPCAB. There were no significant differences with regard to the morbidity and mortality rate among the three groups.
Conclusion:
This study suggests that the simultaneous operation of AAA and OPCAB can be done with the same morbidity and mortality as independent surgical procedures.
