| 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) |
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