Simultaneous coronary and abdominal aortic surgery--a report of two cases.

Myocardial infarction is a major cause of operative mortality following abdominal aortic surgery. For this reason, routine coronary angiography and, if indicated, coronary revascularization prior to aneurysm repair is recommended. Nevertheless, some controversy still exists concerning the risks of aneurysm rupture and myocardial ischemic events when repair or coronary surgery is staged. This report describes two successful cases of simultaneous surgery for an expanding aneurysm and severe coronary artery disease, emphasizing the usefulness of gastroepiploic artery grafting in such cases.