Sugiyama Hironobu, Tobe Satoshi, Nousho Hiroki, Matsuo Tatsuro, Hayashi Taro, Yamaguchi Masahiro, Misato Takuya, Oka Takanori, Tanimura Nobuhiro
Department of Cardiovascular Surgery, Akashi Medical Center, Akashi, Japan.
Kyobu Geka. 2013 Nov;66(12):1096-9.
The operative procedure of extensive aortic aneurysm with ischemic coronary artery disease is controversial. We report a case of arch and descending thoracic aortic aneurysm replacement with coronary artery bypass grafting(CABG)via left thoracotomy. A 70-year-old man followed up by hepatic disease was diagnosed with expanding aortic thoracic aneurysm at the other hospital. He had admission to our hospital for surgical intervention. Computed tomography(CT)revealed arch and descending thoracic aortic aneurysm, and coronary arteriography (CAG) revealed #7 90% and #13 75% stenosis. We performed arch and descending thoracic aortic aneurysm replacement with CABG via left thoracotomy. Replaced synthetic graft and bypass grafts were patent on the postoperative CT. He was discharged at 15th postoperative day with no morbidity.
广泛主动脉瘤合并缺血性冠状动脉疾病的手术操作存在争议。我们报告一例经左胸切口行主动脉弓及降主动脉瘤置换术并冠状动脉旁路移植术(CABG)的病例。一名因肝脏疾病接受随访的70岁男性在另一家医院被诊断为扩张性胸主动脉瘤。他因手术干预入住我院。计算机断层扫描(CT)显示主动脉弓及降主动脉瘤,冠状动脉造影(CAG)显示7号冠状动脉90%狭窄,13号冠状动脉75%狭窄。我们经左胸切口行主动脉弓及降主动脉瘤置换术并CABG。术后CT显示置换的人工血管和旁路血管通畅。他术后第15天出院,无并发症。