Concomitant vascular procedures in conjunction with myocardial revascularization: all or none? A report of a case.

Patients with coronary artery atherosclerosis usually have concomitant peripheral vascular lesions. The authors describe the case of a 65-year-old woman who had multiple symptomatic lesions: severe stenosis of the left main coronary artery and the carotid arteries, a large abdominal aortic aneurysm and bilateral renal artery occlusion. To manage these and to avoid myocardial infarction and cerebrovascular accident at operation, concomitant procedures were performed as follows: coronary artery bypass grafting, aneurysm resection, carotid endarterectomy and revascularization of the larger kidney. Although the patient's hospital stay was prolonged, there was no major morbidity and her recovery was good. She returned to a normal life-style, requiring only hemodialysis on an outpatient basis.