[Surgical treatment for aortic diseases associated with coronary artery stenosis]

Three hundred and one patients undergoing aortic surgery (247 aneurysm cases and 54 arteriosclerotic obstruction cases) were evaluated in respect to the treatment for the associated coronary artery stenosis. Twenty-four among total cases (8%) showed the presence of coronary artery stenosis; 16 cases among aneurysm cases (6.5%) and 8 cases among arteriosclerotic obstruction cases (14.8%). Coronary revascularization was performed in 10 cases and the early operate death was observed in one case. Two abdominal aneurysm cases and 4 arteriosclerotic obstruction cases received two-staged aortic and coronary operation, since either aortic or coronary lesion was considered lethal. However, 3 cases of dissecting aneurysm (type I or II), and case of arteriosclerotic obstruction case having left ventricular aneurysm received simultaneous aortic and coronary surgery, since both of the lesions were highly lethal. These data are consistent with the conclusion that the combined aortic and coronary lesion should be treated with the two-staged operation, and that the simultaneous aortic and coronary surgery should be performed only when the both lesions are lethal.