Combined transdiaphragmatic MIDCAB with right gastroepiploic artery and abdominal aortic aneurysm repair

Combined surgical repair for large abdominal aortic aneurysm and severe sym ptomatic coronary artery disease is a safe and effective procedure. Simulta neous operation for minimally invasive direct coronary artery bypass and ab dominal aortic aneurysm repair were performed on a 75-yr-old man. First, we harvested the right gastroepiploic artery and passed it through the diaphr agma for the right coronary artery revascularization on the beating heart. We then repaired the large abdominal aortic aneurysm (8 cm in diameter) usi ng a Dacron tubular Y-graft. Using the arterial graft and off-pump techniqu e reduces operation time and prevents complications of cardiopulmonary bypa ss in elderly patients with large abdominal aortic aneurysm, while the comb ined approach shortens hospital stay and cost. (C) 2000 The international S ociety for Cardiovascular Surgery. Published by Elsevier Science Ltd. All r ights reserved.