Two cases of colonic necrosis following aortoiliac surgery due to coronary-induced cardiogenic shock.
We report two cases of abdominal aortic aneurysm in which the patent inferior mesenteric arteries were ligated. The patient in Case 1, with occlusion of the right coronary artery, developed sudden bradycardia during surgery, resulting in cardiac arrest. The patient was successfully resuscitated and the operation was completed. In Case 2, acute thrombotic obstruction occurred postoperatively in the stent previously implanted in the left anterior descending coronary artery. Although the thrombus was removed by aspiration, hypotension was sustained. In both cases, colonic necrosis extending from the descending colon to the rectum developed following cardiogenic shock. The affected portion of the colon was resected and a colostomy was constructed. The incidence of coronary arterial disease is high in patients with abdominal aortic aneurysm. The occurrence of cardiac complications is not rare, and may result in catastrophic consequences. Therefore the inferior mesenteric artery should be reimplanted, especially in patients with concomitant heart disease.
Saito
Shunei
S
Department of Cardiovascular Surgery, Shizuoka Saiseikai General Hospital, Shizuoka, Japan. shunei@med.nagoya-u.ac.jp
Shirota
Kazuaki
K
Nakamura
Hajime
H
Sakaguchi
Kenji
K
Ozawa
Katsuo
K
Ueda
Yuichi
Y
D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects; D003106:Colon / Q000473:pathology* / Q000601:surgery; D003125:Colostomy; D003327:Coronary Disease / Q000150:complications*; D017809:Fatal Outcome; D006801:Humans; D007083:Iliac Artery / Q000601:surgery; D008297:Male; D009336:Necrosis / Q000209:etiology / Q000601:surgery; D012007:Rectum / Q000473:pathology / Q000601:surgery; D012770:Shock, Cardiogenic / Q000150:complications* / Q000209:etiology; D014656:Vascular Surgical Procedures / Q000009:adverse effects*