Yamana K, Kosuga K, Uraguchi K, Nakama T, Akashi H, Isomura T, Oishi K
Second Department of Surgery, Kurume University School of Medicine, Japan.
Nihon Geka Gakkai Zasshi. 1989 Sep;90(9):1479-82.
Between 1981 and 1988, 52 patients with dissecting aneurysms were operated and four of them (7.7%) had right coronary dissections that were repaired by Bentall's method with or without right coronary bypass grafting (CABG). Three (8.5%) of 35 patients with thoracic aneurysms had coronary disease. Among them, two had one vessel disease (1VD) and one had 2VD; two underwent temporary axillofemoral bypass grafting (AFBG) without CABG and one underwent extracorporeal circulation with CABG. Eight (5.6%) of 142 patients with abdominal aneurysms had coronary disease. They consisted of three patients with 1VD, two with 2VD and three with 3VD; their ejection fraction rates were 0.46 to 0.75. Three of them underwent temporary AFBG and one first underwent CABG but later underwent abdominal aortic graft replacement. In conclusion, patients with good coronary distal run-off and a low ejection fraction rate (under 0.5) should initially undergo CABG, but for those with poor run-off, temporary AFBG is better to prevent cardiac afterload.
1981年至1988年间，52例患有夹层动脉瘤的患者接受了手术，其中4例（7.7%）发生右冠状动脉夹层，采用Bentall法修复，伴或不伴有右冠状动脉搭桥术（CABG）。35例胸主动脉瘤患者中有3例（8.5%）患有冠心病。其中，2例为单支血管病变（1VD），1例为双支血管病变（2VD）；2例在未行CABG的情况下接受了临时腋股旁路移植术（AFBG），1例在体外循环下行CABG。142例腹主动脉瘤患者中有8例（5.6%）患有冠心病。他们包括3例1VD患者、2例2VD患者和3例3VD患者；其射血分数为0.46至0.75。其中3例接受了临时AFBG，1例先接受了CABG，但后来接受了腹主动脉移植置换术。总之，冠状动脉远端血流良好且射血分数较低（低于0.5）的患者应首先接受CABG，但对于血流较差的患者，临时AFBG更有利于预防心脏后负荷。
