[Surgical treatment of aortic arch aneurysm associated with coronary artery disease].

Graft replacement of the aortic arch aneurysms and concomitant coronary artery bypass grafting (CABG) were performed in the consecutive seven patients for the past five years between 1987 and January 1992, including three (43%) emergency operations. The etiology of aneurysms was atherosclerosis in 4, and aortic dissection in 3. There were one early death (14%) due to MRSA pneumonia, and one late death due to rupture of the abdominal aortic aneurysm 8 months postoperatively. Respiratory failure was frequently complicated immediately after the surgery. Vein grafts were anastomosed to coronary artery during the initial core cooling, and sequential cardioplegia was given through the bypass grafts. Selective cerebral perfusion was carried-out during the reconstruction of the transverse aortic arch and arch vessels in all cases. To achieve sufficient myocardial protection, and to get good postoperative hemodynamics and long-term survivors, it was important to perform the simultaneous CABG at the time of the repair for the aortic arch aneurysm in cases complicated with coronary artery disease.