One-Stage Operation for Ruptured Abdominal Aortic Aneurysm and Acute Myocardial Infarction.
10.4326/jjcvs.28.170
- VernacularTitle:急性心筋梗塞を合併した腹部大動脈りゅう破裂の一期的同時手術例
- Author:
Toru Mizumoto
;
Takane Hiraiwa
;
Toshihiko Kinoshita
;
Hideki Fujii
- Publication Type:Journal Article
- From:Japanese Journal of Cardiovascular Surgery
1999;28(3):170-173
- CountryJapan
- Language:Japanese
-
Abstract:
A 65-year-old man suffered abdominal pain and anterior chest pain due to a ruptured abdominal aortic aneurysm (AAA) and acute myocardial infarction. Abdominal CT scanning demonstrated infrarenal AAA measuring 6.0cm in diameter with retroperitoneal hematoma. Coronary angiography was performed revealing total occlusion of the left anterior descending and 90% stenosis in the circumflex coronary artery. The operation was performed immediately after CAG. After median sternotomy, cardioplumonary bypass was initiated using moderate hypothermia (32.0°C). After completion of CABG, AAA replacement using a Y-shaped prosthesis was performed during extracorporeal circulation. Extracorporeal circulation protects the heart from the hemodynamic changes after aortic clamping or declamping during abdominal aortic surgery. Our experience shows that one-stage operation is a feasible option for patients with AAA and coronary artery disease accompanied by impaired left ventricular function.
