Tamura K, Nakahara H, Furukawa H, Kawauchi J
Department of Cardiovascalar Surgery, Hiroo Metropolitan Hospital, Tokyo, Japan.
Kyobu Geka. 2001 Mar;54(3):215-8.
Two cases are reported of coronary artery bypass graft (CABG) surgery to the proximal left circumflex artery (LCX) system and left anterior descending artery (LAD) system. Both patients suffered from unstable angina due to left main trunk (LMT) lesions and required semi-emergent coronary revascularization. In both cases, the obtuse marginal branch and postero-lateral branch were too small to be grafted, although there are the usual target branches in the LCX system. CABG to the proximal portion (# 11) of LCX in the atrioventricular groove using saphenous vein grafts was performed and good blood flow rates were seen intra-operatively. Both patients recovered uneventfully and had no recurrence of anginal attacks. Postoperative coronary angiography confirmed good graft patency and an adequate coronary blood supply. CABG to LCX (# 11) is feasible without special techniques or tools. This method seems to be useful in patients with LMT lesions or with proximal lesions of LCX in which the branches are too small to be grafted.
报道了两例冠状动脉搭桥术（CABG），分别针对左旋支动脉（LCX）系统近端和左前降支动脉（LAD）系统。两名患者均因左主干（LMT）病变而患有不稳定型心绞痛，需要进行半急诊冠状动脉血运重建。在这两例中，钝缘支和后外侧支过小，无法进行搭桥，尽管LCX系统中有常见的靶血管。使用大隐静脉移植物对房室沟处的LCX近端部分（#11）进行了CABG，术中可见良好的血流速度。两名患者均顺利康复，心绞痛发作未复发。术后冠状动脉造影证实移植物通畅良好，冠状动脉供血充足。对LCX（#11）进行CABG无需特殊技术或工具即可实施。该方法似乎对患有LMT病变或LCX近端病变且分支过小无法进行搭桥的患者有用。
