One-Stage Off-Pump CABG and Y Graft Replacement of the Abdominal Aorta in a Patient with Ischemic Heart Disease and Leriche's Syndrome

(Department of Thoracic and Cardiovascular Surgery, Shingu Medical Center, Shingu, Japan)

Toru Mizumoto Katsutoshi Adachi Katsumoto Hatanaka
A 68-year-old man with unstable angina after old myocardial infarction, and Lerichefs syndrome was admitted. Coronary angiography found 90% stenosis of the left anterior descending artery (LAD), 99% stenosis of the diagonal branch, 99% stenosis of the right coronary artery (RCA), and 90% stenosis of the 4-posterior descending branch (4PD). Left circumflex artery (LCX) was diffusely stenotic and small. Aortography revealed complete occlusion of the infrarenal aorta. Due to the risk of limb-threatening ischemia, we planned simultaneous revascularization of myocardium and the lower extremities. Off-pump coronary artery bypass (OPCAB) was performed first. Subsequently Y graft replacement of abdominal aorta was completed. The postoperative course was uneventful and he was discharged on the 14th day after operation.
@Jpn. J. Cardiovasc. Surg. 33: 410-413 (2004)