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Vascular and Endovascular Surgery
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Combined Endovascular Treatment of a Descending Thoracic Aortic Aneurysm and Off-Pump Myocardial Revascularization

A Case Report

Marcelo R. L. Moura, MD

Department of Vascular Surgery, Università Vita-Salute, IRCCS H. San Raffaele, Milan, Italy

Germano Melissano, MD

Department of Vascular Surgery, Università Vita-Salute, IRCCS H. San Raffaele, Milan, Italy; g.melissano{at}hsr.it

Francesco Maisano, MD

Department of Cardiac Surgery, Università Vita-Salute, IRCCS H. San Raffaele, Milan, Italy

Enrico M. Marone, MD

Efrem Civilini, MD

Department of Vascular Surgery, Università Vita-Salute, IRCCS H. San Raffaele, Milan, Italy

Ottavio Alfieri, MD

Department of Cardiac Surgery, Università Vita-Salute, IRCCS H. San Raffaele, Milan, Italy

Roberto Chiesa, MD

Department of Vascular Surgery, Università Vita-Salute, IRCCS H. San Raffaele, Milan, Italy

Endovascular intervention is an alternative form of treatment for patients with thoracic aortic aneurysms. Coexistent cardiovascular diseases may adversely influence the postoperative course and affect the long-term prognosis. The case of a 76-year-old man with severe coronary artery disease and a thoracic aortic aneurysm is reported. A single-stage procedure of offpump coronary artery revascularization and endoluminal exclusion of the descending thoracic aortic aneurysm was performed. The patient was treated first with off-pump coronary artery bypass graft (left internal mammary artery on the left anterior descending coronary artery and two single venous grafts from ascending aorta to obtuse marginal artery and posterior descending artery). After heart revascularization, two Thoracic Excluder endovascular grafts (34 X 100 and 37 X 100 mm) were implanted to treat the descending thoracic aortic aneurysm. Follow-up with computed tomography angiography showed successful exclusion of the thoracic aneurysm 12 months after the procedure. The patient is well and free of symptoms 18 months later.

Vascular and Endovascular Surgery, Vol. 36, No. 4, 305-309 (2002)
DOI: 10.1177/153857440203600409
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