Matsumiya Goro, Ohtake Shigeaki, Sawa Yoshiki, Ishizaka Tohru, Yoshimine Toshiki, Matsuda Hikaru
Division of Cardiovascular Surgery, Department of Surgery, Course of Interventional Medicine (E1), Osaka University Graduate School of Medicine, 2-2 Yamada-oka, Suita, Osaka 565-0871, Japan.
Jpn J Thorac Cardiovasc Surg. 2002 Feb;50(2):88-91. doi: 10.1007/BF02919672.
We report a case of severe stenosis in the ostium of both the coronary artery and the proximal left vertebral artery and severe aortic regurgitation secondary to Takayasu's aortitis. A 47-year-old woman underwent simultaneous repair consisting of aortic valve replacement, triple coronary artery bypass grafting, and aorto-left vertebral artery bypass. Saphenous vein grafts to 3 coronary arteries and the left vertebral artery were proximally anastomosed on a bovine pericardial patch in the ascending aorta. Since the patient had severe preoperative ischemic symptoms from vertebral-basilar insufficiency, we clamped the vertebral artery during reconstruction under deep hypothermic circulation. The postoperative course was uncomplicated. Simultaneous repair of such multiple lesions requires meticulous planning of surgical procedures and circulatory assist systems.
我们报告一例继发于高安动脉炎的冠状动脉开口及左椎动脉近端严重狭窄和重度主动脉瓣反流病例。一名47岁女性接受了包括主动脉瓣置换、冠状动脉三支搭桥及主动脉-左椎动脉搭桥的同期修复手术。三支冠状动脉及左椎动脉的大隐静脉移植物近端吻合于升主动脉的牛心包补片上。由于患者术前因椎基底动脉供血不足出现严重缺血症状，我们在深低温循环下重建时夹闭了椎动脉。术后病程顺利。同时修复此类多发病变需要精心规划手术操作及循环辅助系统。
