Ohkado A, Nakano K, Nakatani H, Gomi A, Sugiyama N, Itoh A, Ohnishi S, Itai T, Namiki S, Hayashi H, Nirei T, Hirata N
Department of Cardiovascular Surgery, Kanto Medical Center, Tokyo, Japan.
Kyobu Geka. 2000 Feb;53(2):97-100.
A 86-year-patient who had acute myocardial infarction and critical cardiogenic shock was diagnosed to have the left main trunk (LMT) and triple vessel disease. Emergent coronary artery bypass grafting to the left anterior descending artery was performed using saphenous vein graft without cardiopulmonary bypass through median sternotomy. On the 41st postoperative day, catheter intervention was performed to the remaining lesions by stenting of LMT and percutaneous transluminal coronary angioplasty to the right coronary artery lesions. Tl scintigraphy showed remarkable reduction of myocardial ischemia. Hybrid therapy is the effective new strategy for critical cases which cannot be successfully and securely treated by medical or surgical approach alone.
一名86岁的急性心肌梗死合并严重心源性休克患者被诊断为左主干（LMT）和三支血管病变。通过正中胸骨切开术，在非体外循环下使用大隐静脉移植术对左前降支进行了急诊冠状动脉旁路移植术。术后第41天，通过对LMT进行支架置入和对右冠状动脉病变进行经皮冠状动脉腔内血管成形术，对剩余病变进行了导管介入治疗。铊闪烁扫描显示心肌缺血明显减轻。对于仅靠药物或手术方法无法成功安全治疗的重症病例，杂交治疗是一种有效的新策略。
