Takayama Hiroo, Otsuka Toshiya, Kubota Hiroshi, Shibata Ko, Kitamura Tadashi, Takamoto Shinichi
Department of Cardiothoracic Surgery, Faculty of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
Jpn J Thorac Cardiovasc Surg. 2004 Mar;52(3):158-60. doi: 10.1007/s11748-004-0135-7.
A 55-year-old man with severe infective endocarditis underwent aortic root replacement using a homograft concomitant with saphenous vein grafting to the left anterior descending artery. The patient developed angina due to stenosis of the proximal anastomosis of the vein graft accompanied by a 2-cm pseudoaneurysm. This complex lesion was successfully managed with urgent coronary artery bypass surgery through a left thoracotomy, followed by a redo replacement of the old aortic homograft. The mechanism and the basis of the treatment strategy adopted for this case are described.
一名55岁患有严重感染性心内膜炎的男性接受了同种异体主动脉根部置换术，并同时进行了大隐静脉移植至左前降支动脉的手术。该患者因静脉移植近端吻合口狭窄并伴有一个2厘米的假性动脉瘤而出现心绞痛。通过左胸开胸进行紧急冠状动脉搭桥手术成功处理了这一复杂病变，随后再次替换了旧的同种异体主动脉移植片。描述了该病例所采用治疗策略的机制和依据。
