[Contraversions of simultaneous coronary artery bypass grafting, abdominal aorta and major vascular operations].
OBJECTIVE
Patients with coronary artery disease associated with peripheral vascular disease often raise problems of operative strategy. Particularly the sequence of procedures in which lesions must be treated is a frequent source of controversy. The aim of this study was to research surgical strategy, early and late clinical outcomes for patients undergoing one-stage coronary and abdominal aortic or magistral artery surgical interventions.


METHODS
From 1999 through 2002 twenty eight patients underwent combined major vascular reconstruction with coronary artery bypass grafting.


RESULTS
In group with abdominal aortic aneurysm 2 patients died. One patient died from intraoperative acute abdominal aortic aneurysm and bifemoral artery thrombosis with continuous bleeding from the vascular prosthesis in association with disseminated intravascular coagulation. Another patient died from bleeding from the sudden multiple gastroduodenal ulcers on post-operative day eight. In groups with peripheral vascular occlusive disease and carotid artery disease there were no deaths.


CONCLUSIONS
The data show that combined coronary artery bypass grafting and vascular operations are feasible on patients with concomitant carotid artery or peripheral vascular occlusive disease. Management of CAD associated with abdominal aortic aneurysm remains controversial.
Benetis
Rimantas
R
Clinic of Cardiac Surgery, Kaunas University of Medicine, Eiveniu 2, 3007 Kaunas. inciura@takas.lt
Inciūra
Donatas
D
Jakutis
Antanas
A
Putelis
Rimantas
R
Giedraitis
Saulius
S
D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D001157:Arterial Occlusive Diseases / Q000601:surgery*; D013504:Cardiovascular Surgical Procedures; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D004691:Endarterectomy; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000601:surgery; D011183:Postoperative Complications; D011860:Radiography, Abdominal; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome