Natsha Noor, Najjar Roua, Warasna Haya J M, Awad Mohammad Y H, Alhadad Baha, Marzouqa Bisher, Qabaja Murad
Al-Ahli Hospital, Hebron, Palestine.
Faculty of Medicine, Palestine Polytechnic University, Hebron, Palestine.
Ann Med Surg (Lond). 2024 Nov 14;86(12):7436-7443. doi: 10.1097/MS9.0000000000002719. eCollection 2024 Dec.
Coronary artery disease is a prevalent cardiovascular condition and the leading cause of morbidity and mortality worldwide. The management of orthopedic injuries requiring surgical fixation is particularly complex in patients with comorbidities such as diabetes mellitus and hypertension (HTN). Coordinating the sequence, timing, and execution of coronary artery bypass grafting (CABG) and orthopedic fixation requires careful consideration of the patient's overall health, surgical risks, and recovery potential.
A 55-year-old male presented with a right distal tibial fracture following a fall. His medical history included HTN, type 2 diabetes mellitus, and Kyrle's skin disease. During his hospital stay, he was diagnosed with non-ST-segment elevation myocardial infarction. Severe multivessel Coronary artery disease was confirmed by catheterization. After interdisciplinary consultation, simultaneous CABG and open reduction and internal fixation of the tibial fracture were performed. He was discharged in good condition and showed positive recovery during a 1-month follow-up.
This case highlights the complexities of managing patients with multiple comorbidities who require both cardiac and orthopedic surgeries. This simultaneous approach allows for efficient treatment, leading to a shorter hospital stay and recovery period. This report supports the feasibility and benefits of simultaneous surgery in complex clinical scenarios, although further studies are required to establish broader guidelines.
Our case emphasizes the importance of a multidisciplinary approach for managing patients with multiple comorbidities who require concurrent surgical intervention. Preoperative planning and speciality coordination ensured optimal outcomes. Further research is needed to develop standardized guidelines for intraoperative care of patients undergoing simultaneous procedures.
冠状动脉疾病是一种常见的心血管疾病,也是全球发病和死亡的主要原因。对于患有糖尿病和高血压(HTN)等合并症的患者,需要手术固定的骨科损伤的管理尤为复杂。协调冠状动脉旁路移植术(CABG)和骨科固定的顺序、时机和实施需要仔细考虑患者的整体健康状况、手术风险和恢复潜力。
一名55岁男性因跌倒后出现右胫骨远端骨折就诊。他的病史包括高血压、2型糖尿病和凯尔氏皮肤病。在住院期间,他被诊断为非ST段抬高型心肌梗死。通过导管检查确诊为严重多支冠状动脉疾病。经过多学科会诊,同时进行了冠状动脉旁路移植术和胫骨骨折切开复位内固定术。他出院时情况良好,在1个月的随访中显示出积极的恢复情况。
本病例突出了管理需要心脏和骨科手术的多种合并症患者的复杂性。这种同时进行的方法允许进行高效治疗,从而缩短住院时间和恢复期。本报告支持在复杂临床情况下同时手术的可行性和益处,尽管需要进一步研究以建立更广泛的指南。
我们的病例强调了多学科方法对于管理需要同时进行手术干预的多种合并症患者的重要性。术前规划和专科协调确保了最佳结果。需要进一步研究以制定同时进行手术患者术中护理的标准化指南。