Simultaneous operations for abdominal aortic aneurysm and liver cancer complicated by severe ischemic heart disease: report of a case.
We performed successful simultaneous operations for an abdominal aortic aneurysm (AAA) and liver cancer in a patient complicated by severe ischemic heart disease. A 59-year-old man with a history of liver dysfunction presented with acute epigastric pain. Abdominal computed tomography findings of ascites and a liver tumor indicated a diagnosis of ruptured hepatocellular carcinoma. He had a concomitant 65-mm AAA and a 48-mm right common iliac aneurysm. Elective surgery was scheduled because of his good general condition. Although triple-vessel disease was detected preoperatively, there were no graftable coronary arteries. The aneurysms were repaired first to utilize intra-aortic balloon pumping (IABP) during resection of the liver cancer, followed by left lateral segmentectomy. Perioperative hemodynamics were maintained by administering catecholamines and vasodilators, without the need for IABP. The patient was discharged on the 21st postoperative day without any complications, and no recurrence of liver cancer has been found in the 5 months since his operation.
Manabe
Hideaki
H
First Department of Surgery, Gifu University School of Medicine, 40 Tsukasa-machi, 500-8705, Gifu, Japan.
Takagi
Hisato
H
Mori
Yoshio
Y
Iwata
Hisashi
H
Sakamoto
Kenichi
K
Yamada
Takuya
T
Yasumura
Mikio
M
Umeda
Yukio
Y
Matsuno
Yukihiro
Y
Shimokawa
Kuniyasu
K
Hirose
Hajime
H
D017544:Aortic Aneurysm, Abdominal / Q000150:complications / Q000601:surgery*; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000601:surgery*; D017023:Coronary Angiography; D006498:Hepatectomy; D006801:Humans; D017543:Iliac Aneurysm / Q000150:complications / Q000601:surgery; D007423:Intra-Aortic Balloon Pumping; D008113:Liver Neoplasms / Q000150:complications / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000150:complications* / Q000000981:diagnostic imaging; D013997:Time Factors