title: Combined transdiaphragmatic off-pump and minimally invasive coronary artery bypass with right gastroepiploic artery and abdominal aortic aneurysm repair.
abstract: METHODS
  Male, 74 FINAL DIAGNOSIS: Abdominal aortic aneurysm (AAA) Symptoms: Palpable abdominal mass Medication: - Clinical Procedure: Abdominal aortic aneurysm repair Specialty: Surgery.
  
  
  OBJECTIVE
  Rare disease.
  
  
  BACKGROUND
  Coronary artery disease is common in elderly patients with abdominal aortic aneurysms. Here we report a case of the combination of surgical repair for abdominal aortic aneurysm and off-pump and minimally invasive coronary artery bypass surgery.
  
  
  METHODS
  A 74-year-old man who presented at our clinic with chest pain was diagnosed with an abdominal aortic aneurysm. His medical history included right coronary artery stenting. Physical examination revealed a pulsatile abdominal mass on the left side and palpable peripheral pulses. Computed tomography scans showed an infrarenal abdominal aneurysm with a 61-mm enlargement. Coronary angiography revealed 80% stenosis in the stent within the right coronary artery and 20% stenosis in the left main coronary artery. The patient underwent elective coronary artery bypass grafting and abdominal aortic aneurysm repair. Abdominal aortic aneurysm repair and transdiaphragmatic off-pump and minimal invasive coronary artery bypass grafting with right gastroepiploic artery were performed simultaneously in a single surgery.
  
  
  CONCLUSIONS
  We report this case to emphasize the safety and effectiveness of transdiaphragmatic off-pump and minimally invasive coronary artery bypass surgery with abdominal aortic aneurysm repair. This combined approach shortens hospital stay and decreases cost.
authors.affiliation: Department of Cardiovascular Surgery, Hospitalium Hospitals Camlica, Istanbul, Turkey.
authors.forename: Onur
authors.initials: O
authors.lastname: Gürer
authors.forename: Ismail
authors.initials: I
authors.lastname: Haberal
authors.forename: Deniz
authors.initials: D
authors.lastname: Ozsoy
keywords: abdominal aortic aneurysm; beating heart; coronary artery bypass