Minami Tomoyuki, Suzuki Shinichi, Isomatsu Yukihisa, Kasama Keiichiro, Matsuki Yusuke, Masuda Munetaka
Department of Cardiovascular Surgery, Yokohama City University, Yokohama, Japan.
Kyobu Geka. 2010 Aug;63(9):809-12.
A 54-year-old-man on hemodialysis was admitted to the hospital because of effort angina. A coronary angiography revealed multiple stenoses including 90% stenosis in the left main trunk. Coronary artery bypass grafting (CABG) was performed with Y-composite grafts constructed by the right internal thoracic artery (RITA) and the free gastroepiploic artery (GEA) which were anastomosed to left anterior descending artery (LAD) and the diagonal branch (D1) using the off-pump technique. After completion of anastomosis, Photo Dynamic Eye (PDE) system showed fluorescence not in the free GEA but at the anastomotic site of GEA to D1. Because the graft spasm of GEA was diagnosed by PDE, papaverine solution was sprayed to the graft, which resolved the spasm and re-anastomosis was avoided. PDE system is a useful tool for the diagnosis of graft spasm, and may contribute to improvement of quality of CABG.
一名接受血液透析的54岁男性因劳力性心绞痛入院。冠状动脉造影显示多处狭窄，包括左主干90%狭窄。采用非体外循环技术，使用右胸廓内动脉（RITA）和游离胃网膜动脉（GEA）构建Y型复合移植物，将其与左前降支动脉（LAD）和对角支（D1）吻合，进行冠状动脉旁路移植术（CABG）。吻合完成后，光动力眼（PDE）系统显示荧光不在游离的GEA处，而是在GEA与D1的吻合部位。由于通过PDE诊断出GEA移植物痉挛，遂向移植物喷洒罂粟碱溶液，痉挛得以缓解，避免了再次吻合。PDE系统是诊断移植物痉挛的有用工具，可能有助于提高CABG的质量。
