A Case of Simultaneous Surgery of Minimal Invasive Direct Coronary Artery Bypass Grafting and Endovascular Aneurysm Repair in a Patient with Severe Kyphoscoliosis

rather than catheter intervention. And sur gical AAA repair was thought to be risky due to his respiratory dysfunction. A 75 years old male patient with severe kyphoscoliosis suffered from both coronary artery disease (CAD) and abdominal aortic aneurysm (AAA). Coronary angiography and multi-detector computed tomography showed severe stenosis of left anterior descending (LAD) artery. Difficulty of the catheterization into left coronary due to severe aortic meander suggested difficulty of catheter intervention. Computed tomography revealed an infrarenal AAA measuring 51 mm. The patient also had respiratory dysfunction. Two-staged surgery for both CAD and AAA were considered higher risk for the patient, simultaneous surgery of minimal invasive direct coronary artery bypass grafting (MIDCAB) and endovascular aneurysm repair (EVAR) was selected. The operation was performed safely, and postoperative course was uneventful. Although the candidate of the simultaneous operation was limited, this procedure provided a new alternative for the treatment of combined case of CAD and AAA.