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[A new technique of simultaneous revascularization of coronary vessels and lower limbs. 4 cases]
J N Fabiani1, V A Jebara, C Acar
1Département de Chirurgie cardiovasculaire, hôpital Broussais, Paris.
Insights
Combined surgical management for coronary and aorto-iliac atherosclerosis is challenging. A novel ascending aorta to bifemoral graft technique enables simultaneous coronary artery bypass grafting and lower limb revascularization without peritoneal entry.
Area of Science:
- Cardiovascular Surgery
- Vascular Surgery
- Atherosclerosis Research
Context:
- Management of patients with concurrent coronary and aorto-iliac atherosclerosis presents unique surgical challenges.
- Existing treatment paradigms often involve staged procedures, increasing patient risk and healthcare burden.
- Optimal timing and approach for combined revascularization remain debated.
Purpose:
- To describe a surgical technique for simultaneous management of coronary and aorto-iliac atherosclerosis.
- To evaluate the feasibility and safety of an ascending aorta to bifemoral graft for combined procedures.
- To offer an alternative approach that avoids abdominal cavity entry.
Summary:
- A surgical technique involving an ascending aorta to bifemoral graft is presented for patients with concomitant coronary and aorto-iliac atherosclerosis.
- This method allows for combined coronary artery bypass grafting and lower limb revascularization in a single operative setting.
- The described approach bypasses the need for peritoneal incision, potentially reducing surgical morbidity.
Impact:
- Provides a potentially less invasive option for complex cardiovascular and peripheral vascular disease patients.
- May simplify the surgical management of combined coronary and aorto-iliac disease.
- Offers a new strategy for improving outcomes in patients with multi-level atherosclerosis.
Abstract:
Management of patients with concomitant coronary and aorto-iliac atherosclerosis is controversial. It is universally accepted that coronary artery surgery should precede aorto-iliac reconstruction. The technique described consists of an ascending aorta to bifemoral graft. This technique allows combined surgery of the coronary arteries and to the lower limbs without opening the peritoneum.