Simultaneous myocardial and supra-aortic trunks revascularization

Area of Science:

• Cardiovascular Surgery
• Vascular Surgery
• Interventional Cardiology

Background:

• A 58-year-old female presented with three-vessel coronary artery disease and unstable angina refractory to medical management.
• Preoperative assessment revealed severe obstructive lesions in the brachiocephalic trunk origin, left common carotid origin, and left internal carotid artery.

Observation:

• The patient required urgent coronary artery bypass graft (CABG) surgery.
• Simultaneous surgical intervention included supra-aortic trunk revascularization (extra-anatomic bypass) and carotid endarterectomy.

Findings:

• The patient experienced an uneventful recovery following the combined surgical procedure.
• Discharge occurred on the seventh postoperative day.

Implications:

• This case demonstrates the feasibility and safety of a combined CABG, supra-aortic trunk revascularization, and carotid endarterectomy in a single procedure.
• The patient remained symptomless two years post-procedure, highlighting the long-term efficacy of this comprehensive surgical approach for complex cardiovascular and cerebrovascular disease.