Wariishi S, Kanemitsu N, Okabe M, Nakamura T, Kitamura F
Kochi Municipal Hospital, Japan.
Kyobu Geka. 2000 Jul;53(7):586-9.
A patient was a 65-year-old female who had a complaint of palpitation was diagnosed aortic valve stenosis due to congenital bicuspid aortic valve with pseudotendon by the echocardiographic examination. We suspected left single coronary artery by the aortography and the coronary artery angiography. Aortic valve replacement and resection of pseudotendon was performed with Carbomedics supra-annular aortic valve (21 A). During surgery, persistent left superior vena cava was detected. High-posterior take-off right coronary artery was casually detected at aortic closure. Ventricular fibrillation due to insufficient supply of cardioplegic solution at right coronary area frequently occurred after cardio-pulmonary bypass and percutaneous cardiopulmonary support was required. The patient was discharged 32 days after the operation. Preoperative and intraoperative evaluation was important in the case of aortic valvular disease.
一名65岁女性患者，因心悸就诊，经超声心动图检查诊断为先天性二叶式主动脉瓣伴假腱索导致的主动脉瓣狭窄。通过主动脉造影和冠状动脉造影，我们怀疑存在左单支冠状动脉。使用Carbomedics瓣环上主动脉瓣（21 A）进行了主动脉瓣置换和假腱索切除术。手术过程中，发现了永存左上腔静脉。在主动脉关闭时偶然发现了高位后起的右冠状动脉。体外循环后，右冠状动脉区域因心脏停搏液供应不足频繁发生心室颤动，需要进行经皮心肺支持。患者术后32天出院。对于主动脉瓣疾病患者，术前和术中评估非常重要。
