Surgical stratery for abdominal aortic aneurysm with coronary artery disease

Coronary artery disease (CAD) and abdominal aortic aneurysm (AAA) frequently coexist. One-stage surgery of coronary artery bypass grafting (CABG) and AAA repair is recommended for the treatment of patients having a combination of severe CAD and large AAA. Fifty-three patients underwent simultaneous CABG and AAA repair. By operative methods, we classified them into 3 groups; on-pump CABG and AAA repair group (group A: n=13), AAA repair and off-pump CABG using partial sternotomy group (group B: n=23) and those using full sternotomy group (group C: n=16). It was evaluated which operative method was superior. Off-pump method was superior to on-pump method. A problem of simultaneous CABG and AAA repair was postoperative respiratory complication. This study suggests that the minimally invasive methods should be used for one-stage operation of CABG and AAA repair.