Korean J Thorac Cardiovasc Surg.  1997 Jul;30(7):724-728.

Surgical Correction of Thoracic Aortic Aneurysm Associated with Coronary Artery Disease: A Case Report

• Seo JW
• Bang JH
• Pyun SH
• Choi PJ
• Sung SC
• Woo JS

Abstract

We experienced a case of thoracic aortic aneurysm combined with coronary artery disease. A 68-year-old man complained of anginal pain in the left anterior chest and nonspecific pain in the posterior chest. The aneurysm was extending from left subclavian artery to the diaphragm and sign of impending rupture was noted in the chest CT. Coronary angiograms revealed significant obstruction of left circumflex coronary artery(>95%) and left anterior descending artery(>50%). Exposure was obtained through the left posterolateral thoracotomy incision in the 4th intercostal space and then partial femoro-femoral cardio- pulmonary bypass was established. After aortic cross clamping, the aneurysmal sac was opened and repaired with interposition of 26 mm Hemashield graft. Under the beating heart with femoro-femoral cardiopulmonary bypass, aorto-left circumflex coronary bypass with autogenous saphenous vein used as conduit was performed. Postoperatively multiple cerebral infarction ensued due to intraoperative hypovolemic shock and hypoxic brain damage during cardiopulmonary bypass. Currently, the patient's mental status is drowsy and in an improving state.

Keyword

Aneurysm, dissecting; Aortic aneurysm, descending; Coronary artery disease; Coronary artery bypass

MeSH Terms

Aged
Aneurysm
Aneurysm, Dissecting
Aortic Aneurysm, Thoracic*
Cardiopulmonary Bypass
Cerebral Infarction
Constriction
Coronary Artery Bypass
Coronary Artery Disease*
Coronary Vessels*
Diaphragm
Heart
Humans
Hypoxia, Brain
Rupture
Saphenous Vein
Shock
Subclavian Artery
Thoracotomy
Thorax
Tomography, X-Ray Computed
Transplants