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[大动脉炎综合征中的左冠状动脉开口狭窄——用于近端吻合的补片镶嵌移植技术]

[Left coronary ostial stenosis in aortitis syndrome--patch mounted graft technique for proximal anastomosis].

作者信息

Yokoyama M, Yamada T, Nakahara H, Oshma N, Tanabe S, Irie Y

机构信息

Department of Cardiovascular Surgery, Dokkyo University School of Medicine, Koshigaya Hospital, Saitama, Japan.

出版信息

Nihon Kyobu Geka Gakkai Zasshi. 1990 Apr;38(4):692-7.

PMID:2373901
Abstract

Late restenosis or total occlusion of proximal aortic anastomosis frequently occurs due to intimal proliferation in aortitis CABG patients although successful early postoperatively. A Gore-Tex patch (diameter 20 mm) mounted grafts to LAD and CX with a single ostium was sutured in the inflammatory aorta to prevent late occlusion in a 40-year-old female patient. Postoperative CAG a month after showed a patent graft to LAD and improved exercise treadmill test. Graft to Cx occluded due to competed flow from LAD. No aneurysm was found in the proximal anastomosis. Tissue nonpermeable Gore-Tex mounted graft is considered to be suitable for CABG in aortitis patients with the high incidence of late occlusion.

摘要

尽管在术后早期取得了成功,但主动脉炎冠状动脉旁路移植术(CABG)患者常因内膜增生而出现近端主动脉吻合口的晚期再狭窄或完全闭塞。一名40岁女性患者,在炎性主动脉中缝合了一个带有单个开口、直径20毫米的聚四氟乙烯(Gore-Tex)补片,该补片将移植物连接到左前降支(LAD)和左旋支(CX),以防止晚期闭塞。术后一个月的冠状动脉造影(CAG)显示,连接到LAD的移植物通畅,运动平板试验结果改善。连接到CX的移植物因来自LAD的竞争性血流而闭塞。在近端吻合口中未发现动脉瘤。组织不可渗透的Gore-Tex补片移植物被认为适用于晚期闭塞发生率高的主动脉炎患者的CABG。

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