Skip to main content

Advertisement

Log in

Simultaneous operation of off pump coronary artery bypass and abdominal aortic aneurysm repair

  • Original Article
  • Published:
The Japanese Journal of Thoracic and Cardiovascular Surgery Aims and scope Submit manuscript

Abstract

Objectives: Coronary artery disease (CAD) and abdominal aortic aneurysms (AAA) commonly coexist. However, each disease treatment complicates the management of the other. In this study, we evaluate whether a simultaneous operation of AAA repair and off pump coronary artery bypass (OPCAB) would be safe and acceptable, compared with either procedure alone. Subjects and Methods: We retrospectively reviewed all patients who underwent simultaneous AAA repair and OPCAB (AAA/OPCAB, n=18), compared AAA repair alone (AAA, n=239) and OPCAB alone (OPCAB, n=137) from June 1999 to December 2003. There were no significant differences with regard to age or gender, but the AAA/OPCAB group had significantly larger aneurysms (60.6 vs. 53.2 mm) and significantly lower ejection fractions (EF) (54.9 vs. 60.3%). Results: The patients in the AAA/OPCAB group underwent a significantly longer operative time than AAA, OPCAB (403 vs. 360,296 minutes, respectively), there was significantly greater blood loss (726 vs. 426, 462 ml), and more transfusion required (8.13 vs. 1.69, 2.8 units). The number of bypass grafts in AAA/OPCAB group (1–5 per patients) was significantly smaller (1.78 vs. 2.93). The AAA/OPCAB patients had a significantly longer hospital stay than the AAA (38 vs. 22 days), but was not significantly longer than the OPCAB. There were no significant differences with regard to the morbidity and mortality rate among the three groups. Conclusion: This study suggests that the simultaneous operation of AAA and OPCAB can be done with the same morbidity and mortality as independent surgical procedures. Key words: coronary artery bypass grafting, abdominal aortic aneurysm, off pump coronary artery bypass, simultaneous operation

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Hertzer NR, Beven EG, Young JR, O’Hara PJ, Ruschhaupt WF 3rd, Graor RA, et al. Coronary artery disease in peripheral vascular patients: A classification of 1000 coronary angiograms and results of surgical management. Ann Surg 1984; 199: 223–33.

    Article  PubMed  CAS  Google Scholar 

  2. Baumgartner FJ, Gheissari A, Capouya ER, Panagiotides GP, Katouzian A, Yokoyama T. Technical aspects of total revascularization in off-pump coronary bypass via sternotomy approach. Ann Thorac Surg 1999; 67: 1653–8.

    Article  PubMed  CAS  Google Scholar 

  3. Bergersen L, Kiernan MS, McFarlane G, Case TD, Ricci MA. Prevalence of abdominal aortic aneurysms in patients undergoing coronary artery bypass. Ann Vase Surg 1998; 12: 101–5.

    Article  CAS  Google Scholar 

  4. Thurmond AS, Semler HJ. Abdominal aortic aneurysm: Incidence in a population at risk. J Cardiovasc Surg (Torino) 1986; 27: 457–60.

    CAS  Google Scholar 

  5. Golden MA, Whittemore AD, Donaldson MC, Mannick JA. Selective evaluation and management of coronary artery disease in patients undergoing repair of abdominal aortic aneurysms: A 16-year experience. Ann Surg 1990; 212: 415–23.

    Article  PubMed  CAS  Google Scholar 

  6. Suggs WD, Smith RB 3rd, Weintraub WS, Dodson TF, Salam AA, Motta JC. Selective screening for coronary artery disease in patients undergoing elective repair of abdominal aortic aneurysms. J Vase Surg 1993; 18: 349–57.

    Article  CAS  Google Scholar 

  7. Pocock SJ, Henderson RA, Rickards AF, Hampton JR, King SB 3rd, Hamm CW, et al. Meta-analysis of randomised trials comparing coronary angioplasty with bypass surgery. Lancet 1995; 346: 1184–9.

    Article  PubMed  CAS  Google Scholar 

  8. Hinkamp TJ, Pifarre R, Bakhos M, Blakeman B. Combined myocardial revascularization and abdominal aortic aneurysm repair. Ann Thorac Surg 1991; 51: 470–2.

    Article  PubMed  CAS  Google Scholar 

  9. Ascione R, Iannelli G, Lim KH, Imura H, Spampinato N. One-stage coronary and abdominal aortic operation with or without cardiopulmonary bypass: Early and midterm follow-up. Ann Thorac Surg 2001; 72: 768–75.

    Article  PubMed  CAS  Google Scholar 

  10. Mohr FW, Falk V, Autschbach R, Diegeler A, Schom B, Weyland A, et al. One-stage surgery of coronary arteries and abdominal aorta in patients with impaired left ventricular function. Circulation 1995; 91: 379–85.

    PubMed  CAS  Google Scholar 

  11. Autschbach R, Falk V, Walther T, Vettelschoss M, Diegeler A, Dalichau H, et al. Simultaneous coronary bypass and abdominal aortic surgery in patients with severe coronary disease: Indication and results. Eur J Cardiothorac Surg 1995; 9: 678–84.

    Article  PubMed  CAS  Google Scholar 

  12. Durham SJ, Steed DL, Moosa HH, Makaroun MS, Webster MW. Probability of rupture of an abdominal aortic aneurysm after an unrelated operative procedure: A prospective study. J Vase Surg 1991; 13: 248–52.

    Article  CAS  Google Scholar 

  13. Swanson RJ, Littooy FN, Hunt TK, Stoney RJ. Laparotomy as a precipitating factor in the rupture of intra-abdominal aneurysms. Arch Surg 1980; 115: 299–304.

    PubMed  CAS  Google Scholar 

  14. Nora JD, Pairolero PC, Nivatvongs S, Cherry KJ, Hallett JW, Gloviczki P. Concomitant abdominal aortic aneurysm and colorectal carcinoma: Priority of resection. J Vase Surg 1989; 9: 630–6.

    Article  CAS  Google Scholar 

  15. Paty PS, Darling RC 3rd, Chang BB, Lloyd WE, Kreienberg PB, Shah DM. Repair of large abdominal aortic aneurysm should be performed early after coronary artery bypass surgery. J Vase Surg 2000; 31: 253–9.

    Article  CAS  Google Scholar 

  16. King RC, Parrino PE, Hurst JL, Shockey KS, Tribble CG, Kron IL. Simultaneous coronary artery bypass grafting and abdominal aneurysm repair decreases stay and costs. Ann Thorac Surg 1998; 66: 1273–6.

    Article  PubMed  CAS  Google Scholar 

  17. Korompai FL, Hayward RH, Knight WL. Noncardiac operations combined with coronary artery bypass. Surg Clin North Am 1982; 62: 215–24.

    PubMed  CAS  Google Scholar 

  18. Attia RR, Murphy JD, Snider M, Lappas DG, Darling RC, Lowenstein E. Myocardial ischemia due to infrarenal aortic cross-clamping during aortic surgery in patients with severe coronary artery disease. Circulation 1976; 53: 961–5.

    PubMed  CAS  Google Scholar 

  19. Ascione R, Iannelli G, Spampinato N. Combined coronary artery and abdominal aortic surgery without cardiopulmonary bypass. Tex Heart Inst J 2000; 27: 19–23.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Minami, H., Mukohara, N., Obo, H. et al. Simultaneous operation of off pump coronary artery bypass and abdominal aortic aneurysm repair. Jpn J Thorac Caridovasc Surg 53, 133–137 (2005). https://doi.org/10.1007/s11748-005-0018-6

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11748-005-0018-6

Keywords

Navigation