Concomitant Myocardial Revascularization and Modified Radical Mastectomy: Report of a Case

Abstract

We report a successful concomitant myocardial revascularization with modified mastectomy on a female octogenarian. This patient had suffered from chest tightness for two years, and was proved to have triple-vessel coronary artery disease (CAD) with significant stenotic lesions on her left anterior descending (LAD) and circumflex coronary artery in addition to total occlusion of her right coronary artery with collateral circulation from the left side coronary artery. She also had a palpable mass in her left breast for one year that was proved to be cancer of the breast later. After evaluation of surgical risk, possible complications and prognosis in a combined conference, our surgical team decided to perform percutaneous transluminal coronary angioplasty (PTCA) for circumflex coronary artery first. Then we performed a concomitant minimally invasive direct coronary artery bypass (MIDCAB) with left internal thoracic artery (ITA) bypassing to LAD and a left modified mastectomy with axillary node dissection at the same time through the same surgical incision. The patient withstood the procedure well and was followed up 24 months later without any evidence of recurrence of chest discomfort or the breast cancer. A combination of myocardial revascularization and modified mastectomy seems to be an alternative strategy for patients with CAD and cancer of the left breast.