Combined coronary artery bypass with descending thoracic aorta to bifemoral bypass grafting using minimal invasive...

Area of Science:

• Cardiovascular Surgery
• Vascular Surgery
• Thoracic Surgery

Background:

• Coronary artery disease (CAD) and peripheral vascular disease (PVD) frequently coexist, particularly in aging populations with prevalent risk factors like smoking, diabetes, and obesity.
• Minimizing surgical burden is crucial in high-risk patients to prevent adverse outcomes and reduce morbidity.
• Traditional surgical approaches for combined CAD and PVD often involve median sternotomy.

Observation:

• A case of successful combined coronary artery bypass grafting (CABG) and thoraco-bifemoral bypass for PVD is presented.
• The surgery was performed using a left thoracotomy approach, deviating from the conventional median sternotomy.
• This approach was chosen to mitigate potential morbidity associated with sternotomy in an elderly patient.

Findings:

• The combined CABG and thoraco-bifemoral bypass via left thoracotomy proved to be a successful and reliable surgical strategy.
• The feasibility of this approach is dependent on the specific anatomical characteristics of the vascular lesions.

Implications:

• This case suggests that thoracotomy is a feasible alternative to median sternotomy for combined CABG and PVD surgery in select high-risk patients.
• This approach may offer a way to reduce surgical morbidity in elderly patients with complex cardiovascular and peripheral vascular disease.
• Further investigation into the anatomical considerations and patient selection for this combined thoracotomy approach is warranted.