Simultaneous Management of Unstable Angina and Renal Colic in Ankylosing Spondylitis

Abstract

Background: Ankylosing spondylitis (AS) is a seronegative inf lammatory disease that progressively af f ects the spine and sacroiliac joints. It can also predispose patients to several other pathologies. Renal stones have been rarely reported in patients with AS. Case Presentation: In this case we describe a 54 years old gentleman presented with acute renal colic as well as unstable angina posing a dilemma over the management strategy. We also discuss our management strategy where we carried out simultaneous an-aortic of f pump beating heart CABG as well as retrieval of ureteric stone with satisf actory outcome. Conclusion: Though AS increases the risk of adverse outcomes af ter CABG it is not signif icantly associated with poorer overall mortality and long term outcomes. Theref ore, patients should not be denied surgical revascularization. Awareness of issues around intubation, choice of conduits, access to the aorta, sternal closure, and mobilisation are important f or a satisf actory outcome. The anaortic OPCAB approach, where possible, can ameliorate some of these issues, improve outcomes and minimize f uture reoperation in this challenging subset of patients.