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Ann Thorac Surg 1991;52:805-809
© 1991 The Society of Thoracic Surgeons


Articles

Simultaneous revascularization for critical coronary and peripheral vascular ischemia

T. Carrel, MD*, U. Niederhäuser, MD, M. Pasic, MD, A. Gallino, MD, L. von Segesser, MD, M. Turina, MD

Clinic for Cardiovascular Surgery and Department of Medicine, University Hospital, Zürich, Switzerland

Accepted for publication May 14, 1991.

* Address reprint requests to Dr Carrel, Clinic for Cardiovascular Surgery, University Hospital, Rämistrasse 100, CH-8091 Zürich, Switzerland.

Patients with coronary artery disease can exhibit substantial vascular involvement, and patients with vascular disease have a high incidence of coronary disease. Simultaneous coronary artery bypass grafting and treatment of vascular disease was performed in 32 patients with strong indications for surgical treatment of coronary artery disease and critical peripheral vascular ischemia operated on from 1980 until 1990. Overall hospital mortality was 3.1%; 1 patient died of myocardial infarction 2 days after urgent combined revascularization because of unstable angina pectoris and subacute occlusion of the aortoiliac bifurcation. Early mortality was 0% in patients undergoing elective operations. Eight-year actuarial survival was 87.5%. Combined procedures can be performed with acceptable risk and with encouraging longterm results in this special group of patients; they may improve prognosis in patients with diffuse atherosclerosis.




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