Kihara S, Shimakura T, Hanayama N, Maeba S, Hirasawa Y
Department of Cardiovascular Surgery, Fukuyama Cardiovascular Hospital, Hiroshima, Japan.
Kyobu Geka. 1999 Jun;52(6):501-4.
A 80-year-old Japanese female was diagnosed to have angina pectoris and admitted to our hospital. She had been operated on with mitral valve replacement and coronary artery bypass grafting to right and circumflex coronary artery 4 years before. The coronary angiogram showed significant stenosis with severe calcification in the left anterior descending coronary artery, and it was unsuitable for catheter intervention. The patient also had stenotic left internal thoracic artery and multiple cerebral infarction, but successful off-pump subclavian-coronary artery bypass grafting using saphenous vein graft through small thoracotomy was performed without new neurological deficit. This procedure is useful for patients with left internal thoracic artery unsuitable for MIDCABG, due to quality, size, or injury during preparation.
一名80岁的日本女性被诊断为心绞痛并入住我院。4年前她接受了二尖瓣置换术以及右冠状动脉和左旋支冠状动脉的冠状动脉搭桥术。冠状动脉造影显示左前降支冠状动脉有严重狭窄并伴有严重钙化，不适合进行导管介入治疗。患者还存在左胸廓内动脉狭窄和多发性脑梗死，但通过小切口开胸使用大隐静脉移植成功进行了非体外循环下锁骨下-冠状动脉搭桥术，且未出现新的神经功能缺损。由于准备过程中的质量、大小或损伤等原因，该手术对于左胸廓内动脉不适合进行微创直接冠状动脉搭桥术的患者很有用。
