[Staged operation of multiple aortic aneurysms with myocardial infarction and stenosis of three coronary arteries].
A 69-year-old man with multiple aortic aneurysms was admitted to the university hospital because of increasing the size of aneurysms. A coronary angiogram revealed three vessel disease (LAD at seg 7: 90%, D1: 75%, LCX at seg 13: 95%, RCA at seg 3: recanalization) and left ventriculography showed hypokinesis of the inferior wall. Staged extending operation was performed. Graft replacement of ascending and arch aortic aneurysms associated with coronary artery bypass grafting was done in the first operation. Two months after the 1st operation, thoracoabdominal and infrarenal aortic aneurysms were replaced by synthetic graft and the intercostal arteries (Th10, 11, 12) and the lumbar arteries (L1, 4) were reconstructed with synthetic bypass from the implanted graft. Postoperative course was uneventful and he has been well without any symptoms of paraplegia 26 months after the first operation.
Shimoji
M
M
Second Department of Surgery, Faculty of Medicine, University of the Ryukyus, Okinawa, Japan.
Koja
K
K
Kuniyoshi
Y
Y
Akasaki
M
M
Miyagi
K
K
Kusaba
A
A
D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery*; D006348:Cardiac Surgical Procedures / Q000379:methods; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000150:complications*; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000150:complications*; D012501:Saphenous Vein / Q000637:transplantation