Perioperative Management for Ileus in Patients with Acute Coronary Syndrome

Abstract

We report two cases with severe ischemic coronary disease and ileus because of malignant neoplastic disease.
(Case 1)A 72-year-old man who was diagnosed of ascending colonic cancer with ileus complained chest pain. Emergent cardiac catheterization showed left main trunk disease. He received at first off pump coronary artery bypass(OPCAB) and underwent ascending colectomy 15 days after OPCAB.
(Case 2) A 79-year-old man with ileus by rectal cancer complained chest pain. Cardiac catheterization showed left main trunk disease. Echocardiogram showed low ejection fraction. He received OPCAB and PCI, and thereafter he underwent low anterior resection for the rectal cancer 26 days after coronary revascularization.
Continuous infusions of nicorandil and ladiolol were used during surgeries for maintenance of their hemodynamics. Their postoperative recoveries were smooth and uneventful.