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.

Hypoxic condition of skeletal muscle is caused not only by hypoxia exposure but also by exercise and disease etc. It is thought that clarifying a mechanism of response to hypoxia in vivo is useful for developing better training methods and treatment strategies. However, at present, research dealing with the effects of hypoxic exposure on skeletal muscle have not shown consistent results. Hypoxic exposure results in angiogenesis or muscle atrophy as morphological changes in skeletal muscle. Applications of hypoxic exposure include intermittent hypoxic exposure and hypoxic training, both of which may lead to angiogenesis in a mechanism different from normal hypoxic exposure. In this review, we present some findings on the effects of hypoxia exposure on skeletal muscle and discuss whether satellite cells are involved in promoting angiogenesis by hypoxia.