Ichikawa Seiji, Murakami Fumihiko
Department of Thoracic and Cardiovascular Surgery, Meijo Hospital, Nagoya, Japan.
Kyobu Geka. 2011 Jun;64(6):470-2.
A 69-year-old male with a history of total esophagectomy and substernal placement of the gastric tube for esophageal carcinoma was admitted due to an unstable angina. Cardiac catheterization revealed a severe stenosis just proximal to the left anterior descending coronary artery and a 75% stenosis of the right coronary artery. Intraaortic balloon pumping was started in the catheter laboratory. Off-pump coronary artery bypass grafting was performed through left thoracotomy. The left internal mammary artery could not be utilized as a bypass graft to the left anterior descending artery due to severe substernal adhesion. Percutaneous coronary intervention was selected for the revascularization of the right coronary artery lesion.
一名69岁男性，有食管癌全食管切除术及胃管胸骨后置入史，因不稳定型心绞痛入院。心脏导管检查显示左前降支冠状动脉近端严重狭窄，右冠状动脉狭窄75%。在导管室开始主动脉内球囊反搏。通过左胸切口进行非体外循环冠状动脉搭桥术。由于严重的胸骨后粘连，左乳内动脉无法用作左前降支动脉的搭桥移植物。选择经皮冠状动脉介入治疗来使右冠状动脉病变血管再通。
