Simultaneous radical gastrectomy and coronary artery bypass grafting: a case report

Coexistence of coronary artery disease and cancer with both requiring surgical treatment at the same time is rare. A 74-year-old male underwent elective coronary artery bypass grafting for unstable angina. In preoperative workup, the patient was incidentally discovered to have anaemia secondary to occult blood loss in his stool. This led to a preoperative upper GI endoscopy which showed a gastric carcinoma. Since both conditions required surgery, it was decided to perform simultaneous coronary artery bypass grafting (CABG) followed by distal radical gastrectomy. CABG was done using low-dose heparin, and after closing sternotomy, the radical gastrectomy was performed. Postoperative recovery was uneventful, and patient was discharged in stable condition on day 14. Follow-up after 6 months revealed no recurrence. Feasibility of simultaneous CABG and gastric cancer surgery, in particular, and various management strategies, in general, is discussed.