Gopal Mr, Maskari S, Zacharias S, Valliathu J
Department of Cardiothoracic Surgery, The Royal Hospital, Po Box 1331, Postal Code 111, The Sultanate of Oman.
Images Paediatr Cardiol. 2009 Apr;11(2):9-14.
Coronary artery bypass grafting (CABG) with cardiac vale repair is an uncommon surgery in infants. CABG is technically demanding in infants due to the small size not only of the coronary arteries but also the potential graft arteries. The short and long-term outcome of surgery is not known and thus has largely been avoided.
We report the case histories of two infants in whom CABG was undertaken successfully as a life-saving measure. Case 1: This infant needed an arterial switch operation after which the right coronary artery (RCA) was stenosed resulting in low cardiac output. After the right internal mammary artery (RIMA) was used to anastamose the RCA, the hemodynamic status improved drastically. Case 2: This infant underwent surgical correction for Anomalous Left Coronary Artery from Pulmonary Artery (ALCAPA). Postoperatively, she was in low cardiac output. She was found to have an occluded left coronary artery and mitral regurgitation (MR). After she underwent left internal mammary artery (LIMA) to Left Anterior Descending (LAD) anastamosis and mitral valve repair, the clinical condition improved dramatically.
CABG is an uncommon operation in infants. This surgery is technically difficult. The long term results are not known and there are very few reports for the same. Though such an operation is best avoided, it can be used as a desperate life saving measure.
冠状动脉旁路移植术（CABG）联合心脏瓣膜修复术在婴儿中是一种不常见的手术。由于婴儿不仅冠状动脉细小，而且潜在的移植动脉也细小，CABG在技术上具有挑战性。手术的短期和长期结果尚不清楚，因此在很大程度上一直被避免。
我们报告了两名婴儿成功接受CABG作为挽救生命措施的病例史。病例1：这名婴儿在进行动脉调转手术后，右冠状动脉（RCA）狭窄，导致心输出量降低。在使用右乳内动脉（RIMA）与RCA吻合后，血流动力学状态急剧改善。病例2：这名婴儿接受了肺动脉起源异常左冠状动脉（ALCAPA）的手术矫正。术后，她的心输出量较低。发现她有左冠状动脉闭塞和二尖瓣反流（MR）。在她接受左乳内动脉（LIMA）与左前降支（LAD）吻合及二尖瓣修复后，临床状况显著改善。
CABG在婴儿中是一种不常见的手术。该手术在技术上具有难度。长期结果尚不清楚，且相关报道极少。尽管最好避免进行这种手术，但它可以作为一种绝望的挽救生命的措施。
