[HSF] AAA and CABG

[Mitch Lirtzman]

Dr. Sharoni,
First, I would evaluate for EVAR. If the patient is a candidate, and the 
AAA is asymptomatic, I would wait 2-4 weeks post op. Definitely do the CABG 
first. Keep him happy and stable. If not an EVAR candidate, 6 weeks. In 
these instances, I continually reinforce to patient and reassure the family 
the importance of observing for symptoms. ANY abdominal, back or flank pain 
that is not related to last night's burrito (perhaps not in Israel), they 
need to get to the nearest ER, if not mine, and have the doc call me 
directly and "I will operate on the patient any time, day or 
night".  Though these folks are known to be at higher risk for post op 
rupture, that has not been my experience.

Happy Pesach.

Mitch LirtzmanAt 02:55 PM 4/14/2008, you wrote:
>Dear Colleagues,
>I remember this was a discussed issue once - looking for a reference about
>timingg of  CABG operation in a 7 cm AAA - before, after - concomitant?
>We have a Pt with a 7 cm AAA who was sent by anaesthesia for a cath based on
>abnormal perfusion scan (cleared by cardiology for operation based on this
>scan) sure enough - TVD - needs CABG.
>Needs some urgent answers Based on the literature and personal experience.
>Thanks in advance
>Erez Sharoni
>Israel
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