caa a22 4500 397496400 CHVBK 20180308164522.0 cr unu---uuuuu 161202e199512 xx s 000 0 eng 10.1016/S1010-7940(05)80124-1 doi (NATIONALLICENCE)oxford-10.1016/S1010-7940(05)80124-1 Simultaneous coronary bypass and abdominal aortic surgery in patients with severe coronary disease--indication and results [Elektronische Daten] In patients with severe coronary artery disease (CAD) abdominal aorticsurgery is still associated with high morbidity and mortality rates. Somepatients will present with both symptomatic CAD and large, symptomaticabdominal aortic aneurysms (AAA) or end-stage aortic occlusive disease(AOD) that does not allow for a two-stage procedure. We report a series of29 patients who underwent simultaneous coronary artery bypass graft surgery(CABG) and abdominal aortic surgery (25 AAA, 4 AOD). In the AAA group therewere 23 males and 2 females with a mean age of 68 years (50-80). Sixteenpatients presented with severe three-vessel disease. Ten patients hadunstable angina. Aortic stenosis or insufficiency was present in two andone patient, respectively. Four patients with three-vessel disease and anejection fraction below 30% presented with end-stage AOD and critical limbischemia. Coronary bypass graft surgery was performed first. With thepatient still on partial cardiopulmonary bypass, abdominal aortic surgerywas carried out. Patients received an average of 3.1 coronary bypassgrafts. Additionally, three aortic valves were implanted. Fourteen tubegrafts and 15 bi-iliacal or bifemoral bifurcation grafts were placed in theabdominal aortic position. Additional vascular surgery was performed infive patients. Intraoperative management was without complication in allbut one patient, who had intraoperative myocardial infarction (AOD group).Hospital mortality was 8% (2/25) in the AAA group. There was howeversubstantial hospital morbidity (52.2%). The mean follow-up is 20.5 +/- 2.5months. The actuarial survival rate at 3 years is 84.9%. It is concludedthat combined CABG and abdominal aortic surgery is a reasonable option forpatients who present with both severe CAD and symptomatic abdominal aorticdisease. The continuation of CPB during aortic surgery may effectivelyprevent the adverse effects of infrarenal aortic clamping on a failingventricle. © Springer-Verlag European Journal of Cardio-Thoracic Surgery Elsevier Science B.V. 9/12(1995-12), 678-683 1010-7940 9:12<678 1995 9 ejcts https://doi.org/10.1016/S1010-7940(05)80124-1 text/html Onlinezugriff via DOI 1 abstract jats NATIONALLICENCE 856 40 https://doi.org/10.1016/S1010-7940(05)80124-1 text/html Onlinezugriff via DOI NATIONALLICENCE 773 0- European Journal of Cardio-Thoracic Surgery Elsevier Science B.V 9/12(1995-12), 678-683 1010-7940 9:12<678 1995 9 ejcts Metadata rights reserved CC BY-NC-4.0 http://creativecommons.org/licenses/by-nc/4.0 nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-oxford