Abstract
An 80-year-old man suffering from angina on exertion due to stenosis of the left main coronary artery, heart failure due to mitral valve regurgitation, and an abdominal aortic aneurysm (AAA) was successfully operated on with simultaneous surgical procedures. A coronary cineangiography revealed 90% stenosis of the left main coronary artery in segment 5, and 99% and 90% stenosis in segments 2 and 4AV, respectively, of the right coronary artery. Left ventriculography and aortography showed moderate mitral valve regurgitation and the presence of a fusiform-shaped AAA with a maximum diameter of 6 cm. It was thought that insertion of an intraaortic balloon pump (IABP) would prove difficult due to AAA; therefore, simultaneous surgery combining triple coronary artery bypass grafting (CABG), mitral valve plasty, and prosthetic replacement of the AAA was undertaken. The patient's postoperative course was uneventful, and subsequent angiography showed good patency of all coronary bypass grafts and the abdominal prosthesis, along with the disappearance of mitral regurgitation. This patient's clinical course suggests that an extended surgical procedure is effective for the treatment of complicated cardiovascular disease, even in very elderly patients.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Hertzer NR, Young JR, Beven EG, Young JR, O'Hara PJ, Ruschhaupt WF, Graor RA (1986) Late results of coronary bypass in peripheral vascular patients: I. five-year survival according to age and clinical cardiac status. Cleve Clin J Med 53:133–143
Hertzer NR (1980) Fetal myocardial infarction following abdominal aortic aneurysm resection. Three-hundred-forty-three patients followed 6–11 years postoperatively. Ann Surg 192:667–673
Hertzer NR, Young JR, Beven EG, Young JR, O'Hara PJ, Ruschhaupt WF, Graor RA, Dewolfe VG, Maljovec LC (1984) Coronary artery disease in peripheral vascular patients. A classification of 100 coronary angiograms and results of surgical management. Ann Surg 199:223–233
Taguchi Y, Fukushima Y, Ueda K, Kyo S, Yokote Y, Omoto R (1996) Surgical management of abdominal aortic aneurysms in patients with ischemic heart disease. J Jpn Coll Angiol 36:457–461
Hertzer NR, Young JR, Kramer JR (1979) Routine coronary angiogram prior to elective aortic reconstruction-Results of elective myocardial revascularization in patients with peripheral vascular disease. Arch Surg 114:1336–1344
Craford ES, Morris GC Jr, Howell JF (1978) Operative risk in patients with previous coronary bypass. Ann Thorac Surg 26:215–221
Salmon NW, Page US, Bigelow JC (1991) Coronary artery bypass grafting in elderly patients. Comparative results in a consecutive series of 469 patients older than 75 years. J Thorac Cardiovasc Surg 101:209–218
Johansson G, Nydahl S, Olofsson P, Swedenborg J (1990) Survival in patients with abdominal aortic aneurysms. Comparison between operative and nonoperative management. Eur J Vasc Surg 4:497–502
Diel JT, Cali RF, Hertzer NR, Beven EG (1983) Complication of abdominal aortic reconstruction. Ann Surg 197:223–233
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Sueda, T., Orihashi, K., Morita, S. et al. Combined coronary artery bypass, mitral valve plasty, and abdominal aneurysmectomy in an 80-year-old patient: Report of a case. Surg Today 28, 95–97 (1998). https://doi.org/10.1007/BF02483617
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02483617