A Case of Concomitant Coronary Artery Disease, Abdominal Aortic Aneurysm, and Bile Duct Cancer

(Department of Cardiovascular Surgery, Koshigaya Hospital Dokkyo University School of Medicine, Koshigaya, Japan)

Soichi Shioguchi Yoshihito Irie Shigeyoshi Gon
Koyu Tanaka Takao Imazeki
We report a rare case of concomitant coronary artery disease, abdominal aortic aneurysm, and bile duct cancer. A 65-year-old man, who had been recognized to have jaundice in late November 2005, was found to have bile duct cancer, an abdominal aortic aneurysm with a diameter of 70mm, and coronary artery disease (with two severely diseased branches). To avoid extended operation, a two-stage operation was performed; at the first operation, off-pump coronary artery bypass surgery (LITA to LAD and Ao-SVG to 4PD) and replacement of the abdominal aortic aneurysm by an artificial blood vessel with minimal incision were implemented. In 21 days after the cardiovascular surgery, the patient underwent pylorus-preserving pancreatoduodenectomy (modified Child method) in the second operation. After the two-stage operation, the patient showed a favorable outcome without any major complications. On the basis of the outcome of two-stage operation we successfully applied, we discuss the strategy for treatment of patients having both cardiovascular and abdominal malignant diseases, with reference to the literature.
@Jpn. J. Cardiovasc. Surg. 36: 92-95 (2007)