Original article: cardiovascularOne-stage coronary and abdominal aortic operation with or without cardiopulmonary bypass: early and midterm follow-up
Section snippets
Material and methods
Our unit accepts patients referred from the southwest region of Italy. Routine practice includes cardiac and major vascular operation. Therefore, in the presence of concomitant symptoms in different vascular territories, patients undergo complete investigation, which includes cardiac catheterization, abdominal computed tomographic scanning, and aortic and peripheral angiography, where appropriate. The combined approach was used for patients with CAD (Canadian Cardiovascular Society class III to
Results
Baseline and operative characteristics are shown in Table 1, Table 2, respectively. Twenty-eight patients (13 on-pump group, 15 off-pump group) were seen with a history of previous MI. Of the 11 patients with AOD, only one patient in each group presented with signs of lower limb ischemia, whereas the remnant had intermittent claudication. No differences were observed between groups in regard to mean number of grafts placed and distribution of grafts. One patient (aged 58 years) in the off-pump
Comment
Severe correctable CAD is identified in a third of patients with abdominal aortic disease 9, 27. The mortality rate is reported to be 10% ± 20% in elderly high-risk patients undergoing conventional CABG and in elderly high-risk patients seen with poor left ventricular function, a heavily calcified aorta, or associated cerebral, pulmonary, renal, hepatic, and vascular comorbid diseases 28, 29. Conversely, OPCAB avoids exposure to the detrimental effects of CPB and cardioplegic arrest on
References (34)
- et al.
Simultaneous coronary artery bypass grafting and abdominal aneurysm repair decreases stay and costs
Ann Thorac Surg
(1998) - et al.
Abdominal aortic aneurysm repair during cardiopulmonary bypassrationale for a combined approach
Cardiovasc Surg
(1997) - et al.
The effect of coronary bypass on the outcome of peripheral vascular operations in 1093 patients
J Vasc Surg
(1986) - et al.
Combined cardiac and abdominal aortic aneurysm operations. The dual operation on cardiopulmonary bypass
J Thorac Cardiovasc Surg
(1992) - et al.
Combined coronary artery bypass grafting and abdominal aortic aneurysm repair
Am J Surg
(1998) Concombined coronary and vascular surgery is not better than separate procedures
J Cardiothorac Vasc Anesth
(1998)- et al.
Coronary artery bypass grafting without cardiopulmonary bypass
Ann Thorac Surg
(1996) - et al.
Coronary artery bypass without cardiopulmonary bypass
Ann Thorac Surg
(1992) - et al.
Inflammatory response after myocardial revascularization with or without cardiopulmonary bypass
Ann Thorac Surg
(1998) - et al.
On-pump versus off-pump coronary revascularizationevaluation of renal function
Ann Thorac Surg
(1999)
Quantitative angiographic assessment of coronary anastomoses performed without cardiopulmonary bypass
J Thorac Cardiovasc Surg
Off-pump multivessel coronary bypass via sternotomy is safe and effective
Ann Thorac Surg
Systematic off-pump coronary artery revascularization in multivessel diseaseexperience of three hundred cases
J Thorac Cardiovasc Surg
Primary coronary artery bypass grafting without cardiopulmonary bypass in impaired left ventricular function
Ann Thorac Surg
Myocardial revascularization in the elderly using beating heart coronary artery bypass surgery
Ann Thorac Surg
On-pump, beating-heart coronary artery operations in high-risk patientsan acceptable trade-off?
Ann Thorac Surg
Economic outcome of off-pump coronary artery bypass surgerya prospective randomized study
Ann Thorac Surg
Cited by (29)
Acute Thrombosis of Abdominal Aortic Aneurysm During Cardiac Surgery
2009, Annals of Thoracic SurgeryCitation Excerpt :Moreover, both surgeons and anesthesiologists are usually fully aware of the existence of the aneurysm and its potential complications, and the patient is in an ideal situation for emergency repair. Combined cardiac surgery and AAA repair, with or without CPB, has been proposed to avoid this complication in high-risk patients with large aneurysms [5–7]. However, this is recommended mainly in symptomatic AAA to prevent the risk of rupture [6]; thrombosis of an AAA during cardiac surgery has never been a real concern for the cardiac surgeon, and this event has been reported only once in the medical literature [8], which occurred in the course of coronary artery surgery on a beating heart without cardiopulmonary bypass.
Combined complex open heart surgery and infra-renal aortic aneurysm repair
2008, International Journal of CardiologyCitation Excerpt :Aortic stenting and/or off-pump coronary revascularization [4] appear to decrease postoperative complications in high-risk patients.
Combined abdominal aortic aneurysm repair and coronary artery bypass: Presentation of 13 cases and review of the literature
2006, Annals of Vascular SurgeryOpen surgical repair of subrenal abdominal aortic aneurysms
2005, EMC - ChirurgieInfrarenal abdominal aortic aneurysm rupture and severe symptomatic coronary artery disease: Rapid combined transdiaphragmatic off-pump coronary surgery and abdominal aortic aneurysm repair
2005, Journal of Thoracic and Cardiovascular SurgeryCoronary artery disease
2003, Current Problems in Surgery