Simultaneous Minimally Invasive Direct Coronary Artery Bypass and Repair of a Penetrating Atherosclerotic Ulcer of the Descending Thoracic Aorta: Report of a Case

A 70-year-old man with a descending aortic aneurysm was admitted to the hospital because of an abnormal chest X-ray. The chest computed tomography and magnetic resonance angiography findings showed a saccular aneurysm at the descending thoracic aorta. A preoperative coronary arteriogram showed 75% stenosis of the left anterior descending coronary artery and 99% stenosis of the right coronary artery. A simultaneous minimally invasive direct coronary artery bypass (MIDCAB for two vessels) and a descending aortic aneurysm repair were performed without any complications. A pathological examination showed the aneurysm to be a pseudoaneurysm originating from a penetrating atherosclerotic ulcer.