COMBINED CORONARY-ARTERY BYPASS-GRAFTING AND ABDOMINAL AORTIC-ANEURYSM REPAIR

BACKGROUND: We report here the results of combined coronary artery byp ass grafting (CABG) and abdominal aortic aneurysm (AAA) repair and the factors associated with higher mortality following this procedure. ME THODS: The authors performed a retrospective chart review of 26 patien ts who underwent combined CABG and AAA repair between March 1990 and O ctober 1996. RESULTS: NO postoperative myocardial infarction or major cardiac complications were noted. A morbidity rate of 38% (n = 10) and mortality rate of 11% (n = 3) were noted. Comparative analysis of non survivors (n = 3) versus survivors (n = 23) revealed the following: ej ection fraction (EF) was significantly lower (33% +/- 3% versus 44% +/ - 14%, P <0.05), duration of cardiopulmonary bypass (CPB) was signific antly longer (239 +/- 122 minutes versus 141 +/- 54 minutes, P <0.05), and incidence of postoperative respiratory failure (67% versus 17%, P = 0.001) were significantly higher in nonsurvivors. No differences in mean age, gender distribution, incidence of hypertension or diabetes were noted between the groups. CONCLUSIONS: Combined CABG and AAA, rep air protected patients from postoperative aneurysm rupture and myocard ial infarction. Poor EF, prolonged CPB, and postoperative respiratory failure were associated with higher mortality. Am J Surg. 1998;176:144 -146. (C) 1998 by Excerpta Medica, Inc.