A Case Report of One-Staged Coronary Artery Bypass Grafting and Revascularization of the Lower Extremities for Severe Ischemic Heart Disease and Leriche's Syndrome

Tatsuichiro Seto Hiroto Kitahara Yuko Wada
Tsuneo Nakajima Takehiko Furusawa Tamaki Takano
Hirohumi Nakano Jun Amano

(Second Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan)

A 44-year-old man was given a diagnosis of severe ischemic heart disease and Leriche's syndrome. He had critical ischemia in the lower extremities and ischemic gangrene in a toe of the left foot. We planned a one-stage operation for these fatal diseases. To prevent irreversible ischemia of the lower limbs after mobilization of internal thoracic arteries or during extra-corporeal circulation, we performed aorto-ilio femoral bypass grafting with extra-peritoneal approach first. Then conventional coronary artery bypass grafting was carried out for three coronary arteries with bilateral internal thoracic arteries (ITAs) and the saphenous vein. The postoperative course was uneventful.@
@@Jpn. J. Cardiovasc. Surg. 31F146-149(2002)