Kazui T, Komatsu S
Department of Thoracic and Cardiovascular Surgery, Sapporo Medical College, Japan.
Nihon Geka Gakkai Zasshi. 1989 Sep;90(9):1463-6.
Preoperative coronary angiography showed that the significant coronary artery disease (CAD) was present in 47% of patients with thoracic aortic aneurysm (TAA), abdominal aortic aneurysm (AAA), or aortoiliac occlusive disease (A.I). Fifty-seven patients underwent the both coronary artery and great vessel diseases on the simultaneous or sequential stage. As CAD, 13 patients had one vessel disease (VD), 18 had two-VD, 26 had three-VD and 4 of them had left main trunk lesions. As great vessel diseases, 23 patients had A-I, 20 had AAA, 8 had TAA, 5 had TAA+AAA, and 1 had TAA+A-I. There were 4 early deaths (7%) in 57 patients, and 4 (3%) in total 120 coronary and great vessel's operative procedures. The 5-year survival rates were 57.4 +/- 15.5% for TAA, 87.1 +/- 8.5% for AAA and 63.9 +/- 11.1% for A-I, which were not significantly different from those of patients without CAD, respectively except for TAA. The present data suggest that preoperative coronary angiography and CABG in the selected patients may have the beneficial effects on survival and quality of life.
术前冠状动脉造影显示，47%的胸主动脉瘤（TAA）、腹主动脉瘤（AAA）或主-髂动脉闭塞性疾病（A.I）患者存在显著冠状动脉疾病（CAD）。57例患者在同期或分期接受了冠状动脉和大血管疾病治疗。作为CAD，13例患者为单支血管病变（VD），18例为双支血管病变，26例为三支血管病变，其中4例有左主干病变。作为大血管疾病，23例患者为主-髂动脉闭塞性疾病，20例为腹主动脉瘤，8例为胸主动脉瘤，5例为胸主动脉瘤+腹主动脉瘤，1例为胸主动脉瘤+主-髂动脉闭塞性疾病。57例患者中有4例（7%）早期死亡，120例冠状动脉和大血管手术中共有4例（3%）早期死亡。TAA的5年生存率为57.4±15.5%，AAA为87.1±8.5%，A-I为63.9±11.1%，除TAA外，与无CAD患者的生存率无显著差异。目前的数据表明，术前冠状动脉造影和对选定患者进行冠状动脉旁路移植术可能对生存率和生活质量有有益影响。
