The Outcome of One-stage Operation of Coronary Artery Bypass Grafting and Abdominal Aortic Aneurysm Repair

(Department of Cardiovascular Surgery, Kumamoto Central Hospital, Kumamoto, Japan and Second Department of Surgery, Faculty of Medicine, Kagoshima University*, Kagoshima, Japan)

Kim Hyun IL Ryuzo Sakata* Takaaki Koshiji
Yoshihiro Nakayama Masashi Ura Yoshio Arai
Yuji Morishima Hideyuki Fumoto
Sixteen patients of mean age 68.4 years (range 55-83) underwent one-stage coronary artery bypass grafting (CABG) and abdominal aortic aneurysm (AAA) repair at our institution between January 1998 and September 1999. The mean number of diseased coronary arteries was 2.4 as revealed by selective coronary arteriography and the location of the aneurysms, which consisted of 14 infrarenal types and one juxtarenal type. On CT scans, the size of the aneurysms ranged from 4.3-9.0cm with a mean diameter of 5.7cm. Routinely CABG was performed first under standard techniques using cardiopulmonary bypass. After the patient was weaned from the cardiopulmonary bypass and judged hemodynamically stable, the AAA repair was performed with heparin reversed but the chest wall remained open. An average of 2.9 coronary bypass grafts were performed, including mean 1.8 arterial grafts used. With respect to the AAA repair, one straight and fifteen bifurcated grafts were implanted, and one left renal artery was simultaneously reconstructed. There were neither operative and hospital deaths and any serious postoperative complications. Our detailed preoperative assessment suggests that, under cautious perioperative management, the one-stage operation of CABG and AAA repair is both effective and practical in carefully selected patients, who do not have extremely poor renal dysfunction, left ventricular dysfunction and respiratory dysfunction.
@Jpn. J. Cardiovasc. Surg. 30: 129-133 (2001)