Abstract
On a case of ischemic heart disease lesions including Left Main Trunk concurrent with ASO in the iliac-femoral arterial lesion, we parf ormed a two-stage operation to obtain satisfactory results. The case is a 73-year-old male. Cardiac catheterization revealed segment 1: total occlusion, segment 5: 75% stenosis, segment 6: 90% stenosis and segment 12: 90% stenosis. Angiography of the region below the abdominal aorta revealed a total occlusion of the left common iliac artery and stenosis of the right common iliac artery. Y-grafting was performed first. An end-to-end anastomosis was made in the inf rarenal abdominal aorta on the proximal site and in the right common iliac artery and left femoral artery on the distal site. After the distal anastomosis on one side, a decline in the cardiac function was noted, and the patient did not respond to conservative therapy. A collateral branch was provided from a graft on the proximal site at the site of anastomosis with the left femoral artery, and IABP was inserted. CABG (SVG to LAD seg 8) was performed the following day. Hemodynamics was stable immediately after surgery, so IABP was removed. The patient followed a satisfactory post-operative course and was discharged about one month after surgery
