Higashi S, Enoki C, Matsubara T
Department of Cardiovascular Surgery, Shizuoka Red Cross Hospital, 8-2 Ootemachi, Shizuoka 420-0853, Japan.
Jpn J Thorac Cardiovasc Surg. 2001 Jan;49(1):79-81. doi: 10.1007/BF02913128.
The patient was a 70-year-old male with a chief complaint of chest pain. Coronary angiography revealed a saccular aneurysm of 11 mm in diameter at the furcation of the left main coronary artery. Triple vessel disease was also seen. At surgery, it was judged that the risk to rupture of the aneurysm was high because the aneurysmal wall was very thin. Therefore, the blood flow into the aneurysm was blocked, and coronary artery bypass grafting was performed. In a pathological study on the aneurysmal wall, no atherosclerotic and no inflammatory changes were found, but acidic mucopolysaccharides were detected in the tunica media. Coronary aneurysms with coronary stenosis in the elderly have been reported to be arteriosclerotic without exception. Here we present this rare case of a left main coronary artery aneurysm with coronary stenosis in an old-aged patient, considered to be due to metabolic abnormalities in the smooth muscle cells.
该患者为70岁男性，主诉胸痛。冠状动脉造影显示左主冠状动脉分叉处有一个直径11毫米的囊状动脉瘤。还发现有三支血管病变。手术中，由于动脉瘤壁非常薄，判断动脉瘤破裂风险很高。因此，阻断了流入动脉瘤的血流，并进行了冠状动脉旁路移植术。在对动脉瘤壁的病理研究中，未发现动脉粥样硬化和炎症变化，但在中膜检测到酸性粘多糖。据报道，老年患者伴有冠状动脉狭窄的冠状动脉瘤无一例外均为动脉粥样硬化性。在此，我们呈现这例罕见的老年患者左主冠状动脉瘤伴冠状动脉狭窄病例，考虑其病因是平滑肌细胞的代谢异常。
