| Surgery of Abdominal Aortic Aneurysm
Associated with Coronary Artery Disease:Simultaneous or Two Staged
Operation |
(Department of Thoracic Cardiovascular Surgery,
Showa University Fujigaoka Hospital, Yokohama, Japan and First
Department of Surgery, Showa University*, Tokyo, Japan)
| Hiroyuki Tanaka |
Takashi Narisawa |
Takanobu Mori |
| Mikio Masuda |
Daijirou Kishi |
Takashi Suzuki |
| Toshihiro Takaba* |
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|
Coronary artery disease (CAD) was
evaluated by noninvasive examination in abdominal aortic aneurysm
(AAA) patients. A simultaneous operation or a 2-staged operation
was performed depending on the seriousness of the condition when
both diseases were combined. A total of 36 patients underwent
elective repair of AAA between 1996 and 2001. Coronary angiography
(CAG) was performed only in patients with suspected CAD by dipyridamole
myocardial scintigraphy. Significant CAD was found in 8 patients.
Simultaneous operation was performed in 4 patients, and off-pump
coronary artery bypass grafting (OPCAB) was performed in all
cases of simultaneous operation. In 4 patients receiving 2-staged
operations, 1 standard coronary artery bypass grafting (CABG),
1 OPCAB and 2 percutaneous transluminal coronary angioplasties
(PTCA) were performed prior to AAA surgery. Twenty-eight patients
underwent only AAA operation. Though there were no incidents
of perioperative myocardial infarction or cardiac related deaths
in this group, 2 patients died due to other causes (hemorrhage
and duodenal perforation). In the 8 patients associated with
CAD, 1 patient died of MNMS after simultaneous operation. The
other 7 patients revived their social function soon of the discharge.
Dipyridamole cardiac scintigraphy was considered to be an effective
examination for evaluation of CAD in AAA patients. There was
no need to perform CAG in all AAA patients. The policy of choosing
simultaneous operation or 2-staged operation according to the
seriousness of the 2 diseases seemed to be appropriate.
Jpn. J. Cardiovasc. Surg. 32：197 -200（2003) |
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