[Combined off-pump CABG (OPCAB) and abdominal vascular surgery].
Two simultaneous operations for off-pump CABG (OPCAB) and abdominal vascular surgery were performed safely and effectively. [Case 1] A 52-year-old man was admitted with the right intermittent claudication and angina pectoris. Coronary angiography and aortography showed 90% stenosis of left anterior descending coronary artery (LAD) and the right external iliac artery. The patient underwent 1 CABG using left internal thoracic artery (ITA) without cardiopulmonary bypass and abdominal aorta--the right external iliac bypass simultaneously. Bleeding volume during the operation was only 150 ml. The operation time was 3 hours 50 minutes. [Case 2] A 57-year-old man was referred from the other hospital with complaints of abdominal aortic aneurysm. He had the history of 4 stroke attacks caused by idiopathic aldosteronism. Preoperative coronary angiography and aortography showed severe 3 vessels disease and abdominal aortic aneurysm. First, we harvested bilateral ITAs, the right gastroepiploic artery (GEA) and saphenous vein (SV). The complete revascularization (left ITA-LAD, right ITA-1st diagonal branch, GEA-seg. 4 posterodescending branch, SV graft-posterolateral branch) was performed on the beating heart. Then we repaired the abdominal aortic aneurysm (56 mm in diameter) using a Gelsealed Y-graft. The operative course was uneventful. The operation time was 6 hours 15 minutes. These cases suggested that OPCAB technique combined with abdominal vascular surgery reduced operation time and prevented complication in the patient with the risk of brain trouble.
Nakano
H
H
Department of Cardiovascular Surgery, Tokyo Medical University, Kasumigaura Hospital, Ibaraki, Japan.
Daimon
M
M
Hayashi
K
K
Okamura
H
H
D000787:Angina Pectoris / Q000601:surgery; D001012:Aorta, Abdominal / Q000601:surgery; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery; D002315:Cardiopulmonary Bypass; D001026:Coronary Artery Bypass / Q000379:methods*; D006801:Humans; D007083:Iliac Artery / Q000601:surgery; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods*