[Coronary artery bypass grafting using right gastro-epiploic artery and cholecystectomy]

Area of Science:

• Cardiovascular Surgery
• Gastrointestinal Surgery

Background:

• Coronary artery bypass grafting (CABG) is a common treatment for ischemic heart disease.
• Cholelithiasis (gallstones) often requires surgical intervention, typically cholecystectomy.
• Performing both procedures simultaneously can potentially reduce overall patient morbidity and healthcare costs.

Observation:

• A 59-year-old male patient with ischemic heart disease and cholelithiasis underwent simultaneous CABG using the right gastro-epiploic artery (GEA) and cholecystectomy.
• The CABG procedure utilized standard extracorporeal circulation, with the GEA pedicle passed through the diaphragm.
• The diaphragm opening was secured with fibrin glue, and the cholecystectomy was completed through the same incision without extension, followed by sternal closure.

Findings:

• The patient experienced an uneventful postoperative recovery, with no instances of mediastinitis or other infections.
• Postoperative angiography confirmed excellent patency of the right GEA graft.
• The combined surgical approach was technically successful and well-tolerated.

Implications:

• Simultaneous CABG with GEA and cholecystectomy presents a viable and beneficial option for carefully selected patients.
• This combined strategy may optimize resource utilization and streamline patient care pathways.
• Further studies could explore the long-term outcomes and expanded indications for this combined surgical technique.