[Abdominal aortic aneurysm and horseshoe kidney anomaly]. / Pilvo aortos aneurizma ir pasagos formos inksto anomalija.

Horseshoe kidney is a challenge for vascular surgeon performing abdominal aortic aneurysm repair. First case of successful surgical treatment and positive remote result is described in Lithuanian medical press. Literature review of world surgical treatment experience is given. Operative technique depends upon anomalous kidney vascularization. Three types of vascularization are described. Rational operative approach and necessity of isthmotomy are discussed, investigation methods and treatment algorithm is presented.

[Simultaneous myocardial revascularization and abdominal aortic aneurysm repair (report of a fatal case)]. / Vienmomentine miokardo revaskulizacijos ir pilvo aortos aneurizmos operacija (retos komplikacijos aprasymas).

Patients with coronary disease associated with abdominal aortic aneurysm or aortoiliac occlusive disease often raise problems of operative strategy. In particular, the order in which these lesions should be treated is a frequent source of controversy. Our approach for the past two years has been a combined myocardial revascularization with abdominal aortic reconstruction in patients with both lesions. From 1999 through 2001 seven patients underwent combined abdominal aortic reconstruction with coronary artery bypass grafting. We report here the fatal case of combined coronary artery bypass grafting and abdominal aortic aneurysm repair. Partial heparinization and operation without extracorporeal circulation caused acute thrombosis of abdominal aortic aneurysm and femoral arteries. Our first experience advocates using total heparinisation and cardiopulmonary bypass for combined cardiac-aortic procedures.

[Contraversions of simultaneous coronary artery bypass grafting, abdominal aorta and major vascular operations]. / Kompleksiniu sirdies, aortos ir stambiuju kraujagysliu operaciju kontraversijos.

OBJECTIVE: Patients with coronary artery disease associated with peripheral vascular disease often raise problems of operative strategy. Particularly the sequence of procedures in which lesions must be treated is a frequent source of controversy. The aim of this study was to research surgical strategy, early and late clinical outcomes for patients undergoing one-stage coronary and abdominal aortic or magistral artery surgical interventions. MATERIAL AND METHODS: From 1999 through 2002 twenty eight patients underwent combined major vascular reconstruction with coronary artery bypass grafting. RESULTS: In group with abdominal aortic aneurysm 2 patients died. One patient died from intraoperative acute abdominal aortic aneurysm and bifemoral artery thrombosis with continuous bleeding from the vascular prosthesis in association with disseminated intravascular coagulation. Another patient died from bleeding from the sudden multiple gastroduodenal ulcers on post-operative day eight. In groups with peripheral vascular occlusive disease and carotid artery disease there were no deaths. CONCLUSIONS: The data show that combined coronary artery bypass grafting and vascular operations are feasible on patients with concomitant carotid artery or peripheral vascular occlusive disease. Management of CAD associated with abdominal aortic aneurysm remains controversial.