Surgical Correction of Thoracic Aortic Aneurysm Associated with Coronary Artery Disease: A Case Report.
- Author:
Jeong Wook SEO
1
;
Jung Heui BANG
;
Seung Hwan PYUN
;
Pill Joe CHOI
;
Si Chan SUNG
;
Jong Soo WOO
Author Information
1. Department of Thoracic and Cardiovascular Surgery, College of Medicine, Dong-A University, Korea.
- Publication Type:Case Report
- Keywords:
Aneurysm, dissecting;
Aortic aneurysm, descending;
Coronary artery disease;
Coronary artery bypass
- MeSH:
Aged;
Aneurysm;
Aneurysm, Dissecting;
Aortic Aneurysm, Thoracic*;
Cardiopulmonary Bypass;
Cerebral Infarction;
Constriction;
Coronary Artery Bypass;
Coronary Artery Disease*;
Coronary Vessels*;
Diaphragm;
Heart;
Humans;
Hypoxia, Brain;
Rupture;
Saphenous Vein;
Shock;
Subclavian Artery;
Thoracotomy;
Thorax;
Tomography, X-Ray Computed;
Transplants
- From:The Korean Journal of Thoracic and Cardiovascular Surgery
1997;30(7):724-728
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
We experienced a case of thoracic aortic aneurysm combined with coronary artery disease. A 68-year-old man complained of anginal pain in the left anterior chest and nonspecific pain in the posterior chest. The aneurysm was extending from left subclavian artery to the diaphragm and sign of impending rupture was noted in the chest CT. Coronary angiograms revealed significant obstruction of left circumflex coronary artery(>95%) and left anterior descending artery(>50%). Exposure was obtained through the left posterolateral thoracotomy incision in the 4th intercostal space and then partial femoro-femoral cardio- pulmonary bypass was established. After aortic cross clamping, the aneurysmal sac was opened and repaired with interposition of 26 mm Hemashield graft. Under the beating heart with femoro-femoral cardiopulmonary bypass, aorto-left circumflex coronary bypass with autogenous saphenous vein used as conduit was performed. Postoperatively multiple cerebral infarction ensued due to intraoperative hypovolemic shock and hypoxic brain damage during cardiopulmonary bypass. Currently, the patient's mental status is drowsy and in an improving state.
