title: Concomitant aortoaxillary bypass and coronary artery bypass grafting.
abstract: The optimal revascularization strategy for patients with subclavian and coronary artery disease has not been established. This study assessed the mid-term clinical outcome of concomitant aortoaxillary bypass and coronary artery bypass grafting in 5 patients. A ring-reinforced polytetrafluoroethylene graft was attached to the ascending aorta and led to the proximal segment of the axillary artery via the pleural cavity. Patients were followed up for 2-10 years (mean, 5.4 +/- 3.4 years). Postoperative aortography and angiography demonstrated patent aortoaxillary and coronary bypass grafts in the short-term follow-up of all patients. Two patients with Takayasu aortitis needed re-operations for recurrent angina and annuloaortic dilatation. Another patient required removal of the aortoaxillary bypass graft because of infection, and subsequently underwent a left femoroaxillary bypass one year after the original procedure. Subclavian steal phenomenon did not occur. Aortoaxillary bypass with coronary artery bypass may be an effective option for patients with co-existing subclavian and coronary artery disease.
authors.affiliation: Department of Cardiovascular Surgery, Kinki University School of Medicine, 377-2, Ohno-Higashi, Osaka-Sayama, Osaka 589-8511, Japan. rtc-ryo@med.kindai.ac.jp
authors.forename: Takehiro
authors.initials: T
authors.lastname: Inoue
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Saga
mesh_terms: D000368:Aged; D001011:Aorta / Q000601:surgery*; D001157:Arterial Occlusive Diseases / Q000601:surgery; D001366:Axillary Artery / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation; D002315:Cardiopulmonary Bypass; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011138:Polytetrafluoroethylene; D013348:Subclavian Artery / Q000601:surgery; D016896:Treatment Outcome
chemical_list: D011138:Polytetrafluoroethylene