Surgery of Abdominal Aortic Aneurysm Associated with Coronary Artery Disease: Simultaneous or Two Staged Operation
10.4326/jjcvs.32.197
- VernacularTitle:冠動脈病変を合併した腹部大動脈りゅう手術―同時手術，２期手術の選択―
- Author:
Hiroyuki Tanaka
;
Takashi Narisawa
;
Takanobu Mori
;
Mikio Masuda
;
Daijirou Kishi
;
Takashi Suzuki
;
Toshihiro Takaba
- Publication Type:Journal Article
- From:Japanese Journal of Cardiovascular Surgery
2003;32(4):197-200
- CountryJapan
- Language:Japanese
-
Abstract:
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.
