Abstract
A group of 29 patients with simultaneous coronary disease and abdominal aortic aneurysm
were treated two protocols: Group I, 16 patients had coronary bypass surgery and then
abdominal aortic aneurysm repair at a later date. This required two hospitalizations
and two separate surgeries. Group II, 11 patients, underwent coronary bypass surgery
and repair of abdominal aortic aneurysm (AAA) in one sitting. Group III, 2 patients,
had PTCA prior to AAA repair. There were 3.1 bypass grafts implanted (Group I), vs
2.9 (Groups II) (ns). All abdominal aneurysms were infrarenal and 22 patients had
straight tube graft replacement (76%), and seven bifurcated grafts. Two patients with
angina also had symptomatic AAA. Period of hospitalization, morbidity, mortality,
time of total recovery, hospital costs, and apprehension of patients were analyzed.
There was one death in Group I. In this group, the total recovery time was 4.8 months
vs 2.4 months for Group II. Hospitalization time was 16.2 days in Group I vs 8.2 days
in Group II. The hospital costs were significantly higher in Group I with an average
of $58,950 vs $46,553 in Group II. No deaths occurred in Group II. It is recommended
that if a patient with severe coronary disease requiring surgery also presents with
an AAA of more than 5 cm, he/she should have both conditions operated on in one session
rather than staggering the procedures. It saves time, cost, anxiety, and is well tolerated.
