One-stage Surgery in Patients with Ischemic Heart Combined with Occlusive Peripheral Vascular Disease / 日本心臓血管外科学会雑誌

ABSTRACT

During a period of 5 years from January 1991 to December 1995, one-stage operation was performed on 10 cases with ischemic heart and occlusive peripheral vascular disease, excluding cases combined with AAA (abdominal aortic aneurysm). They were composed of 7 men and 3 women whose mean age at time of surgery was 65.8 years. The mean number of coronary artery bypass grafts made was 2.2. The procedures employed for occlusive peripheral vascular disease were TEA (thromboendarterectomy) of the internal carotid artery in 2 cases, aorta-subclavian bypass in 2 cases, aorta-bilateral common iliac artery bypass in 1 case, interposition of the common iliac artery in 1 case, aorta-external iliac artery bypass in 1 case, F-P (femolo-popliteal) bypass in 3 cases (4 bypasses), and F-T (femolo-tibial) bypass in 1 case. Mean operation time was 428 minutes, mean extracorporeal circulation time was 121 minutes, and mean aortic cross-clamp time was 61 minutes. Blood transfusion was not made in 4 cases. There was one operative death in a case of MNMS (myonephropatic metabolic syndrome) with emergency IABP (intraaortic balloon pumping) insertion following complication of PMI (perioperative myocardial infarction). A comparative study was made with 183 non-emergency cases of CABG (coronary artery bypass graft) conducted during the same period. Operation time was longer in cases of one-stage operation, but no significant difference was observed in operative mortality rate, rate of cases not requiring blood transfusion, days of intubation, and postoperative hospitalization duration. The surgical procedure was relatively safe.