Rc. King et al., SIMULTANEOUS CORONARY-ARTERY BYPASS-GRAFTING AND ABDOMINAL ANEURYSM REPAIR DECREASES STAY AND COSTS, The Annals of thoracic surgery, 66(4), 1998, pp. 1273-1276
Citations number
18
Categorie Soggetti
Surgery,"Cardiac & Cardiovascular System","Respiratory System
Background. Patients with large (greater than or equal to 5.0 cm) abdo
minal aortic aneurysms (AAA) frequently have marked associated coronar
y artery disease. We hypothesized that a single operation for coronary
artery bypass grafting (CABG)/AAA would provide equivalent, if not im
proved, patient care while decreasing postoperative length of stay and
hospital costs compared with staged procedures. Methods. Eleven patie
nts to date have undergone a combined procedure at our institution. Te
n underwent CABG followed by AAA repair, whereas one patient received
an aortic valve replacement before aneurysm repair. We performed a ret
rospective analysis comparing the postoperative length of stay and hos
pital costs for this single procedure to a combined cohort of 20 rando
mly selected patients who either received AAA repair (n = 10) or stand
ard CABG (n = 10) during the same time period. Results. No operative m
ortality has been reported. There were no episodes of neurologic defic
it or cardiac complication after these procedures. The postoperative l
ength of stay was significantly decreased for the CABG/ AAA group comp
ared with the combined postoperative length of stay for the AAA plus C
ABG group (7.44 +/- 0.88 days versus 14.10 +/- 2.00; p = 0.012). Total
hospital costs were also significantly decreased for the CABG/AAA gro
up compared with total hospital costs for the AAA plus CABG group ($22
,941 +/- $1,933 versus $34,076 +/- $2,534; p = 0.003). Conclusions, A
single operation for coronary revascularization and AAA repair is safe
and effective. Simultaneous CABG and AAA repair substantially decreas
es postoperative length of stay and hospital costs while avoiding poss
ible interim aneurysm rupture and repeat anesthesia. (Ann Thorac Surg
1998;66:1273-6) (C) 1998 by The Society of Thoracic Surgeons