Coronary Artery Bypass Grafting Combined with Total Arch Replacement for Severe Coronary Disease Complicated with Multiple Arch Vessel Stenosis

Masashi Yada＊	Kazuo Yamanaka＊	Hisashi Sakaguchi＊＊
Atsushi Iwakura＊＊

（Department of Cardiovascular Surgery, Nara Prefecture General Medical Center＊, Nara, Japan, and Department of Cardiovascular Surgery, Tenri Hospital＊＊, Nara, Japan）

A 72-year-old man was referred to our hospital for coronary artery bypass grafting（CABG）due to asymptomatic severe coronary artery disease. A preoperative CT revealed 99% stenosis of the aberrant right subclavian artery, 90% stenosis at the origin of right common carotid artery, and 75% stenosis at the origin of the left subclavian artery. As he had high risk of a perioperative cerebral ischemic event for CABG, it was difficult to perform a carotid artery stent. We performed a total aortic arch replacement combined with CABG. The postoperative course was uneventful, and he was discharged on the 12th postoperative day.

 

Jpn. J. Cardiovasc. Surg. 48:383-386（2019）

Keywords：coronary artery disease;carotid artery stenosis;aberrant right subclavian artery;total arch replacement;coronary artery bypass grafting