Nishizaki Kazuhiko, Seki Toshio
Department of the Cardiovascular Surgery, Nara Prefectural Mimuro Hospital, Ikoma-gun, Nara, Japan.
Jpn J Thorac Cardiovasc Surg. 2003 Nov;51(11):622-5. doi: 10.1007/BF02736705.
The patients were a 73-year-old man (Case 1) and 56-year-old man (Case 2) who developed angina pectoris and heart failure. Case 2 showed chronic renal failure on hemodialysis. These patients showed posterolateral myocardial ischemia with a patent internal thoracic artery graft to the left anterior descending artery. Left ventricle ejection fraction was 29% and 33%, respectively. Catheter intervention was unsuccessful, so we performed revascularization from the descending aorta to coronary arteries with saphenous vein grafts via a left thoracotomy using an off-pump technique. In case 2, proximal anastomosis was constructed with the Symmetric aortic connector. This procedure appeared to be a very safe and useful method as an option for redo coronary artery bypass grafting in the posterolateral area in patients with patent old grafts and poor left ventricular function.
患者为一名73岁男性（病例1）和一名56岁男性（病例2），他们均出现了心绞痛和心力衰竭。病例2显示处于血液透析状态的慢性肾衰竭。这些患者表现为后外侧心肌缺血，其胸廓内动脉至左前降支动脉的移植血管通畅。左心室射血分数分别为29%和33%。导管介入治疗未成功，因此我们通过左胸廓切开术采用非体外循环技术，用大隐静脉移植血管从降主动脉到冠状动脉进行血运重建。在病例2中，近端吻合采用Symmetric主动脉连接器构建。该手术似乎是一种非常安全且有用的方法，可作为旧移植血管通畅且左心室功能较差的患者在后外侧区域进行再次冠状动脉搭桥术的一种选择。
