[Combined Thoraco-abdominal Aortic Aneurysm Repair and Coronary Artery Bypass Grafting through a Left Thoracotomy]

Area of Science:

• Cardiovascular Surgery
• Thoracic Surgery
• Vascular Surgery

Background:

• Coronary artery disease (CAD) is prevalent in patients with aortic aneurysms, significantly increasing perioperative mortality.
• Combined surgical repair of ascending aorta to aortic arch aneurysms and CAD often utilizes median sternotomy for optimal exposure.
• The optimal surgical strategy for thoraco-abdominal aortic aneurysm (TAAA) concurrent with CAD remains debated.

Observation:

• A 69-year-old male patient presented with TAAA and CAD.
• A novel surgical approach involving left thoracotomy was employed for simultaneous TAAA repair and coronary artery bypass grafting (CABG).
• The left thoracotomy provided adequate surgical exposure for both the thoraco-abdominal aorta and the left anterior descending artery (LAD).

Findings:

• The patient successfully underwent TAAA repair and CABG via a left thoracotomy.
• The LAD was revascularized using a saphenous vein graft anastomosed to the descending aorta.
• The postoperative recovery was uneventful, with discharge on the 13th postoperative day.

Implications:

• Left thoracotomy represents a viable alternative surgical approach for complex TAAA and CAD cases.
• This technique may offer a less invasive option compared to median sternotomy for specific patient profiles.
• Further research is warranted to establish the broader applicability and long-term outcomes of this surgical strategy.