Combined coronary artery bypass grafting and abdominal aortic aneurysm repair

Fifteen patients of mean age 65 years underwent simultaneous coronary artery bypass grafting and abdominal aortic aneurysm repair between 1988 and 1992. Of these 13 had coexistent angina and two had symptomless coronary artery disease detected by preoperative dipyridamole thallium scanning or exercise stress testing. All patients had significant coronary artery disease on coronary angiography. Coronary artery bypass grafting was performed first, with a median number of grafts of 4, a median aortic cross-clamp time of 39 min and a median bypass time of 74 min. Abdominal aortic aneurysm repair followed with a median aortic clamp time of 66 min. Six straight and nine bifurcated grafts were inserted. The median total operating time was 395 min. All patients were managed postoperatively in the cardiothoracic intensive care unit with a median duration of 5 days. The median total hospitalization was 14 days. One patient died of non-cardiac causes; hence the mortality rate was 6.7%. The authors' experience suggests that combined coronary artery bypass grafting and abdominal aortic aneurysm repair is feasible in carefully selected patients.