[Clinical experience of simultaneous aortic operation and coronary artery bypass grafting].
OBJECTIVE
To summarized the experience of simultaneous aortic operation and coronary artery bypass.


METHODS
Between November 1997 and September 2004, thirty-six patients who underwent combined aortic operation and coronary artery bypass graft (CABG) were reviewed with a mean age of (57 +/- 12) years (range 31 to 75). Nineteen patients were suffered from aortic dissection. There were 17 patients of aortic aneurysm, 5 aortic root aneurysm, 5 ascending aortic aneurysm, 4 aortic arch aneurysm, 3 abdominal aneurysm. Preoperational coronary angiography was performed in 1 of 10 acute type A dissection patients. The coronary arteries were involved by dissection in 7 acute type A dissection patients. The artherosclerosis of coronary artery was found during operation in 2 patients. Among 7 patients with chronic type A aortic dissection, coronary angiography was performed in 2, coronary artery was involved by dissection in 2 and coronary arterosclaerosis was founded in 3. There were 2 patients with acute or chronic type B aortic dissection. The stenosis of coronary artery was confirmed by preoperative angiography in the patients with aortic aneurysm. There were 57 coronary bypass grafts, 6 of them were artery grafts, and others were venous grafts.


RESULTS
The mean cardiopulmonary bypass time was (157 +/- 54) min, and the mean aortic cross clamp time was (98 +/- 31) min. Five patients with type A aortic dissection died postoperatively, 3 from heart failure leading to multi organ system failure, 1 from cerebral hernia and one from ischemia of intestinal tract. Postoperative complication included reoperation for hemorrhage in 1 patient, respiratory failure in 1 patient.


CONCLUSIONS
Type A aortic dissection with coronary involvement or arterosclaerosis is associated with high mortality rate. Coronary artery angiography should be performed in the elder than 50 years patient with aortic aneurysm. Combined aortic aneurysm operation and CABG is a safe procedure.
Sun
Li-zhong
LZ
Aortic Surgery Center, Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
Liu
Ning-ning
NN
Chang
Qian
Q
Zhu
Jun-ming
JM
Liu
Yong-min
YM
Liu
Zhi-gang
ZG
D000328:Adult; D000368:Aged; D000784:Aortic Dissection / Q000150:complications / Q000601:surgery*; D001014:Aortic Aneurysm / Q000150:complications / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000150:complications; D003327:Coronary Disease / Q000150:complications / Q000601:surgery*; D005112:Extracorporeal Circulation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies