Kanoh T, Kobayashi S, Yamanaka O, Kasuya H, Ozaki H, Wakiya Y, Amano J, Suzuki A
Juntendo University Urayasu Hospital.
Kokyu To Junkan. 1992 Jun;40(6):621-6.
A 37-year-old woman was admitted to our hospital for post operative coronary angiography. At the age of 17, she was diagnosed as having Takayasu's disease and at that time prednisolone was administered. At the age of 22, she was operated on to receive a coronary artery bypass graft (CABG) because of a 95% isolated stenosis in the left coronary ostium. Pathological specimen obtained from the ascending aorta demonstrated a proliferative stage of Takayasu's aortitis. After the CABG, she married and delivered two children, with the inflammation being kept under control by prednisolone. Coronary angiography performed 13 years after the operation proved the saphenous vein graft to the left anterior descending artery to be still patent. To our knowledge, this case has the longest history of a patent CABG used in an operation to correct the ostial stenosis secondary to Takayasu's disease. According to the previous reports we collected, the long-term patency rate of CABG is 78%, whereas that of ostial endarterectomy is unknown. Whether CABG or endarterectomy is better as an operating method for ostial stenosis due to aortitis is still a controversial point. We hope that reports of further examples will be available in order to help make the final decision.
一名37岁女性因术后冠状动脉造影入住我院。她17岁时被诊断为大动脉炎,当时接受了泼尼松龙治疗。22岁时,由于左冠状动脉口孤立性狭窄95%,她接受了冠状动脉旁路移植术(CABG)。取自升主动脉的病理标本显示为大动脉炎的增殖期。CABG术后,她结婚并育有两个孩子,泼尼松龙使炎症得到控制。术后13年进行的冠状动脉造影显示,左前降支的大隐静脉移植血管仍然通畅。据我们所知,该病例是用于纠正大动脉炎继发的冠状动脉口狭窄的CABG术后通畅时间最长的。根据我们收集的既往报道,CABG的长期通畅率为78%,而冠状动脉口内膜切除术的长期通畅率未知。对于大动脉炎所致冠状动脉口狭窄,CABG和内膜切除术哪种手术方法更好仍是一个有争议的问题。我们希望能有更多病例报道,以帮助做出最终决定。