Saito N, Imanaka K, Kyo S, Tanabe H, Kato M, Ohuchi H, Asano H, Nogaki H
First Department of Surgery, Saitama Medical School, Saitama, Japan.
Kyobu Geka. 2003 Mar;56(3):190-3.
A 52-year-old male with a 13 years history of hemodialysis developed unstable angina. Preoperative examination revealed critical stenoses in 3 coronary arteries and extensive calcification in the ascending aorta. During urgent coronary artery bypass surgery, epiaortic ultrasonography demonstrated a large and markedly mobile atheroma in the ascending aorta. Therefore, he underwent resection of this atheroma using cardiopulmonary bypass and circulatory arrest. His postoperative course was fine. This aggressive strategy for a diseased aorta can be a viable option in selected cases. Epiaortic ultrasonography appeared to be indispensable during surgery for patients like a present one.
一名有13年血液透析史的52岁男性发生了不稳定型心绞痛。术前检查显示3支冠状动脉严重狭窄,升主动脉广泛钙化。在紧急冠状动脉搭桥手术期间,经食管超声心动图显示升主动脉有一个大的、明显可移动的动脉粥样硬化斑块。因此,他在体外循环和循环停止的情况下接受了该动脉粥样硬化斑块切除术。他术后恢复良好。对于病变主动脉的这种积极策略在某些特定病例中可能是一种可行的选择。对于像本例这样的患者,经食管超声心动图在手术期间似乎是必不可少的。