Abdullah Fikri, Mazalan Siti Laura
Cardiothoracic Unit, National University Hospital (HUKM), Kuala Lumpur, Malaysia.
Heart Surg Forum. 2004;7(3):E186-8. doi: 10.1532/HSF98.20033016.
We present an interesting but high-risk case of an obese male patient aged 56 years with dextrocardia and a left diaphragmatic hernia. Anterior myocardial infarction was diagnosed in 1994, and the patient later presented with a history of unstable angina. The diagnosis for this chronic smoker was triple-vessel disease, impaired left ventricular function, chronic renal failure, chronic bronchitis, impaired lung function, pulmonary hypertension, hypertension, diabetes, and chronic active gastritis (EuroSCORE of 10). The patient underwent successful off-pump coronary artery bypass grafting with 3 saphenous vein grafts to the left anterior descending, obtuse marginal, and right posterior descending arteries. He was discharged home 8 days later.
我们报告一例56岁肥胖男性患者的有趣但高风险病例,该患者患有右位心和左膈疝。1994年诊断为前壁心肌梗死,患者后来出现不稳定型心绞痛病史。这位长期吸烟者被诊断为三支血管病变、左心室功能受损、慢性肾衰竭、慢性支气管炎、肺功能受损、肺动脉高压、高血压、糖尿病和慢性活动性胃炎(欧洲心脏手术风险评估系统评分为10分)。患者接受了非体外循环冠状动脉搭桥术,使用3条大隐静脉分别移植到左前降支、钝缘支和右后降支动脉。8天后他出院回家。