Yuasa H, Shimono T, Kimura M, Mizutani T, Yada I, Kusagawa M
Department of Thoracic Surgery, Mie University School of Medicine, Jsu, Japan.
Nihon Geka Gakkai Zasshi. 1989 Sep;90(9):1475-8.
Three hundred and one patients undergoing aortic surgery (247 aneurysm cases and 54 arteriosclerotic obstruction cases) were evaluated in respect to the treatment for the associated coronary artery stenosis. Twenty-four among total cases (8%) showed the presence of coronary artery stenosis; 16 cases among aneurysm cases (6.5%) and 8 cases among arteriosclerotic obstruction cases (14.8%). Coronary revascularization was performed in 10 cases and the early operate death was observed in one case. Two abdominal aneurysm cases and 4 arteriosclerotic obstruction cases received two-staged aortic and coronary operation, since either aortic or coronary lesion was considered lethal. However, 3 cases of dissecting aneurysm (type I or II), and case of arteriosclerotic obstruction case having left ventricular aneurysm received simultaneous aortic and coronary surgery, since both of the lesions were highly lethal. These data are consistent with the conclusion that the combined aortic and coronary lesion should be treated with the two-staged operation, and that the simultaneous aortic and coronary surgery should be performed only when the both lesions are lethal.
对301例行主动脉手术的患者（247例动脉瘤病例和54例动脉硬化阻塞病例）进行了关于相关冠状动脉狭窄治疗的评估。全部病例中有24例（8%）存在冠状动脉狭窄；动脉瘤病例中有16例（6.5%），动脉硬化阻塞病例中有8例（14.8%）。10例患者接受了冠状动脉血运重建，其中1例观察到早期手术死亡。2例腹主动脉瘤病例和4例动脉硬化阻塞病例接受了分期主动脉和冠状动脉手术，因为主动脉或冠状动脉病变被认为是致命的。然而，3例Ⅰ型或Ⅱ型夹层动脉瘤病例以及1例患有左心室动脉瘤的动脉硬化阻塞病例接受了同期主动脉和冠状动脉手术，因为这两种病变都具有高度致死性。这些数据与以下结论一致，即主动脉和冠状动脉联合病变应采用分期手术治疗，只有当两种病变都具有致死性时才应进行同期主动脉和冠状动脉手术。
