Clinical Management of Patients With Abdominal Aortic Aneurysms Combined With Coronary Artery Disease and Multifocal Atherosclerosis

We have analyzed clinical management of 137 patients with atherosclerotic aneurysms of the abdominal aorta combined with coronary artery disease treated during last 10 years in the First Cardiac Surgery Department (Surgery of the Aorta and its Branches) of the Petrovsky National Research Center of Surgery. All patients were subjected to surgery involving both vascular regions: in 130 patients (94.9%) the procedures were staged while 7 patients underwent myocardial revascularization simultaneously with the reconstruction of the abdominal aorta from the minimal access. According to our results staged procedures are safer for patients with atherosclerotic aneurysms of the abdominal aorta combined with coronary artery disease given the organism's limited capacity due to age and comorbidities. Endovascular repair techniques applied both to the coronary arteries and to the abdominal aorta should be always regarded primarily as a gentle form of intervention. In cases where open surgery is required one should try to avoid blood loss, reduce the duration of the procedure and use minimal access surgery when applicable. The overall mortality rate in patients treated for this disorder over the last 10 years was 2.1%.