Combined Coronary Artery Bypass Grafting without Cardiopulmonary Bypass and Abdominal Aortic Replacement.
10.4326/jjcvs.27.327
- VernacularTitle:狭心症，腹部大動脈りゅうに対する心拍動下冠状動脈バイパス術とＹ型人工血管置換術一期的施行の１例
- Author:
Nagahisa Oshima
;
Hiroshi Kiyama
;
Takao Imazeki
- Publication Type:Journal Article
- From:Japanese Journal of Cardiovascular Surgery
1998;27(5):327-330
- CountryJapan
- Language:Japanese
-
Abstract:
We report a 71-year-old man who was successfully treated with simultaneous coronary artery bypass grafting (CABG) and abdominal aortic repair. The patient presented with a combination of long segmental stenosis of the left anterior descending coronary artery and large infrarenal abdominal aortic aneurysm (diameter in 7.8 cm). Because both lesions were serious, one-stage operation of coronary artery and abdominal aorta was carried out. First, CABG was performed under the beating heart without cardiopulmonary bypass. After completion of CABG, the median sternotomy incision was extended down to the pubic symphisis, and abdominal aortic replacement was performed using a standard technique with a gelatin-coated bifurcated graft (Gelseal). The operation was uneventfully finished in 6hr 18min without requiring the use of homologous blood products. Postoperative course was uneventful and he was discharged 15 days after the operation. CABG without cardiopulmonary bypass is a safe and effective method not only in patients with left ventricular dysfunction or calcified aorta, but also in patients requiring a one-stage approach for both myocardial ischemia and abdominal aortic aneurysm.
