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Simultaneous coronary artery disease and achalasia surgery: A novel approach
Rimantas Benetis1, Algimantas Budrikis1, Jonas Gazdziauskas1
1Department of Thoracic and Vascular Surgery, Lithuanian University of Health Sciences, Clinic of Cardiac, Kaunas, Lithuania.
Insights
This study presents a novel simultaneous surgical approach for patients with severe coronary artery disease and achalasia. The combined procedure effectively treated both conditions, offering a new option for complex cardiac and esophageal cases.
Area of Science:
- Cardiovascular Surgery
- Gastrointestinal Surgery
- Minimally Invasive Techniques
Background:
- Severe coronary artery disease necessitates coronary artery bypass grafting.
- Achalasia, a motility disorder of the esophagus, can complicate cardiac surgery.
- Pneumatic dilatation is a common treatment for achalasia.
Observation:
- A 69-year-old female patient presented with unstable angina and exacerbated achalasia symptoms.
- The patient required both coronary artery bypass grafting and treatment for achalasia.
Findings:
- A novel simultaneous surgical technique was performed.
- The procedure involved sternotomy, cardiopulmonary bypass, Heller myotomy, and coronary artery bypass grafting.
- The patient experienced an uneventful postoperative recovery and was discharged on postoperative Day 9.
Implications:
- This combined surgical approach is effective for patients with concurrent severe coronary artery disease and achalasia.
- The technique offers a viable solution for complex cases previously managed with separate interventions.
- Further research into this novel surgical strategy is warranted for broader clinical application.
Abstract:
A 69-year-old female patient presented to cardiac surgery department with unstable angina due to severe coronary artery disease. Coronary artery bypass grafting was indicated; however, the patient's symptoms of achalasia, previously treated by the pneumatic dilatation, exacerbated. Subsequently, the patient underwent simultaneous surgery. After sternotomy, on cardiopulmonary bypass, esophagus was exposed and Heller myotomy was performed. Following cardioplegia, coronary artery bypass grafting was completed. The postoperative course was uneventful, and the patient was discharged on postoperative Day 9. In conclusion, this novel surgical technique can be effectively used in such cases.
