Observational studyJournal of cardiothoracic surgery2026
Early and long-term results in patients undergoing combined coronary and lower extremity revascularization: a retrospective analysis.
Observational study in Journal of cardiothoracic surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe coexistence of coronary artery disease (CAD) and peripheral arterial disease (PAD) is a well-recognized clinical challenge. While a staged revascularization strategy is often preferred, simultaneous surgical intervention may be required in selected high-risk patients.
methodsThis study retrospectively reviewed 15 patients who underwent combined coronary and lower extremity revascularization between May 2001 and April 2015. The majority of patients presented with advanced systemic atherosclerotic disease and critical limb ischemia. Peripheral arterial disease was predominantly characterized by complex aorto-iliac lesions (TASC II type C–D). Fourteen patients underwent median sternotomy and one anterolateral limited thoracotomy. Once coronary bypass surgery was completed, peripheral bypass surgery was performed in the same session. In fourteen patients, the femoral arteries were bypassed with prosthetic grafts descended from the ascending aorta and passed through the preperitoneal abdominal wall tunnel. In one patient, the descending aorta was used as the inflow vessel. Descriptive, Kaplan-Meier analyses were used to evaluate the 30-day postoperative period and long-term follow-up results of our patients.
resultsThe mean age was 54.7 ± 9.1 years, and 93.3% of patients were male. The mean operative time was 272.5 ± 40.8 min. Among patients undergoing on-pump surgery, the mean cardiopulmonary bypass time was 120.4 ± 10.9 min. The 30-day postoperative mortality was observed in 2 patients (13.3%). The patients had a mean follow-up duration of 103.1 ± 70.7 months. During follow-up, 4 patients died due to cardiac causes, 3 from graft-related complications. At 1, 5, and 10 years, peripheral graft patency rates were 92.3%, 76.9%, and 15.4%, respectively.
conclusionsSimultaneous coronary and peripheral revascularization may be considered in highly selected high-risk patients as a bailout strategy when alternative approaches are not feasible. However, the substantial early mortality and poor long-term graft durability observed in this study underscore the need for cautious interpretation and careful patient selection.
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