On-pump coronary artery bypass with concomitant descending thoracic aorta-bi-iliac bypass: A case report
Oğuz Omay1, Zeki Talas1, Özgür Çakır2
1Department of Cardiovascular Surgery, Kocaeli University, Kocaeli, Turkey.
Insights
This study presents a modified Süzer technique for patients with critical coronary artery disease and limb ischemia. This single-stage surgery offers a physiological alternative for complex vascular reconstruction.
Area of Science:
- Cardiovascular Surgery
- Vascular Surgery
- Thoracic Surgery
Background:
- Critical coronary artery disease and critical limb ischemia pose significant clinical challenges.
- Simultaneous cardiac and peripheral revascularization is a complex but potentially viable option.
- The Süzer technique offers a physiological extra-anatomical reconstruction using the descending thoracic aorta for inflow.
Observation:
- A case involving juxtrarenal aortic occlusion and left main coronary artery stenosis was identified.
- The patient required simultaneous treatment for both critical limb ischemia and coronary artery disease.
Findings:
- A modified Süzer technique was successfully employed for simultaneous coronary artery bypass grafting and descending thoracic aorto-bi-iliac bypass.
- This approach utilized the descending thoracic aorta as the inflow source for peripheral revascularization.
Implications:
- This modified Süzer technique provides an alternative to traditional ascending aorta to bifemoral bypass for complex cases.
- It demonstrates a feasible and physiological single-stage solution for combined cardiac and peripheral arterial disease.
- Further research may explore the long-term outcomes and broader applicability of this modified technique.
Abstract:
The presence of critical coronary artery disease and concomitant critical limb ischemia represents a clinical challenge. Single-stage operations for cardiac and peripheral revascularization can be an option in such cases. The "Süzer technique" provides a more physiological extra-anatomical vascular reconstruction by using the descending thoracic aorta as the inflow source. This is an alternative to the more widely used technique of ascending aorta to bifemoral bypass and concomitant coronary revascularization. We report a case of critical limb ischemia with juxtrarenal aortic occlusion and left main coronary artery stenosis treated with concomitant coronary artery bypass grafting and descending thoracic aorto-bi-iliac bypass using a modification of the Süzer technique.
