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[A successful one stage treatment in angina pectoris and intermittent claudication of both legs]
Insights
This study presents a successful surgical case combining aorto-coronary bypass grafting and lower limb revascularization in a single stage. The procedure offers a low-risk solution for patients with both coronary artery disease and peripheral artery disease.
Area of Science:
- Cardiovascular Surgery
- Vascular Surgery
- Surgical Case Report
Background:
- A 62-year-old male presented with angina pectoris and intermittent claudication, indicating multi-level atherosclerosis.
- The patient had a history of acute inferior myocardial infarction treated with percutaneous coronary intervention and newly diagnosed diabetes mellitus.
- The patient desired a single-stage surgical intervention for both coronary artery disease and peripheral artery disease.
Observation:
- The surgical approach involved initial aorto-coronary bypass grafting using a saphenous vein graft under cardiopulmonary bypass.
- Subsequently, aorto-right iliac, left femoral bypass grafting was performed using a Dacron bifurcated graft.
- The entire procedure was completed with a single instance of systemic heparinization.
Findings:
- Successful concomitant aorto-coronary bypass grafting and aorto-right iliac, left femoral bypass grafting was achieved.
- The patient experienced an uneventful postoperative course and was discharged in good condition.
- The case demonstrates the feasibility of simultaneous revascularization for both coronary and lower limb arteries.
Implications:
- Simultaneous aorto-coronary bypass and lower limb revascularization can be performed safely in select patients.
- This combined approach may offer a streamlined treatment strategy for patients with complex cardiovascular and peripheral vascular disease.
- Further studies could explore the long-term outcomes and cost-effectiveness of this combined surgical technique.
Abstract:
A successful surgical case of concomitant aorto-coronary bypass grafting and aorto-right iliac, left femoral bypass grafting was presented. A sixty-two years old male admitted to our institution with complaints of angina pectoris and intermittent claudication of both legs who had a history of acute inferior myocardial infarction for which emergency percutaneous coronary balloon dilatation was carried out prior to this admission. In this admission, he was found out to have diabetes mellitus moreover and he hoped to have one staged operation for two different type of the disease. After general anesthesia, at first, aorto-right coronary bypass grafting with saphenous vein graft was carried out under cardio-pulmonary bypass, then aorto-right iliac, left femoral bypass grafting with a dacron bifurcated graft was made only with one time of systemic heparinization. His postoperative course was uneventful and discharged in good condition. We conclude that simultaneous aorto-coronary bypass and revascularization of both legs can be done with minimal risk.