Combined coronary artery bypass grafting and open abdominal aortic aneurysm repair is a reasonable treatment approach: a systematic review

We reviewed the literature for studies investigating the outcomes of combined 1-stage coronary artery bypass grafting (CABG) and abdominal aortic aneurysm (AAA) open repair (OR) procedures. An electronic search of the English literature was conducted using the PubMed, EMBASE, and Cochrane databases. Age, coronary heart disease severity, AAA size, mean duration from CABG to AAA OR procedures, details of each procedure, mortality, and morbidity rates were analyzed. Between 1994 and 2012, 12 studies (256 patients) with 1-stage treatment fulfilled the inclusion criteria and were analyzed. There were 20 early (30 days) deaths, accounting for a 30-day mortality rate of 7.8%. The early morbidity was 53% (136 of 256). One-stage treatment when necessary can be undertaken with acceptable mortality and reasonable morbidity rates considering the complexity of both the operations. Nowadays, endovascular AAA repair is preferred over OR. The outcomes of combined cardiac surgery and endovascular AAA repair have not been extensively evaluated.

A simple booklet for patient follow-up after endovascular abdominal aortic aneurysm repair procedures

Endovascular abdominal aortic aneurysm (AAA) repair (EVAR) procedures require lifelong patient surveillance for the detection of complications (eg, endoleaks or graft migration). This follow-up may be suboptimal. Between November 2010 and November 2011, a follow-up booklet was provided at hospital discharge to 42 consecutive patients undergoing EVAR for an infrarenal AAA. Each patient was given specific instructions for completion of the booklet at each follow-up examination whether this took place at our hospital or elsewhere. After a mean follow-up of 7 ± 3 months, all patients had fully complied with the instructions. This booklet may be useful for patients who find it difficult to attend follow-up appointments. Additionally, this booklet is useful for patients who move to another town/country or in cases of emergency when patients are admitted to another hospital.