Hiranaka T, Nomura F, Kurozumi K, Mori T, Yagura A
Department of Cardiovascular Surgery, Kinan General Hospital, Wkayama, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1991 Sep;39(9):1825-30.
A 43-year-old male, who had undergone coronary artery bypass grafting 11 years ago, developed exertional chest pain. Selective coronary angiograms revealed severe stenosis and a large aneurysm in the obtuse marginal branch of the circumflex coronary artery. Previous grafts to the left anterior descending coronary artery and diagonal branch were patent. Ligation of the aneurysm and internal mammary artery grafting were performed through a left anterolateral thoracotomy. This approach made it easy to reach the aneurysm and to minimize bleeding during dissecting the adhesions. The patient had an uncomplicated postoperative course, and postoperative coronary angiograms revealed an obstructed aneurysm and a patient internal mammary artery graft. He has done well without recurrence of symptoms.
一名43岁男性，11年前接受过冠状动脉搭桥手术，现出现劳力性胸痛。选择性冠状动脉造影显示回旋支冠状动脉钝缘支严重狭窄并伴有一个大动脉瘤。之前移植到左前降支冠状动脉和对角支的血管通畅。通过左前外侧开胸术进行动脉瘤结扎和乳内动脉移植。这种方法便于到达动脉瘤部位，并在分离粘连时将出血降至最低。患者术后恢复过程顺利，术后冠状动脉造影显示动脉瘤闭塞且乳内动脉移植血管通畅。他恢复良好，症状未复发。
