Ornek Ender, Kundi Harun, Kiziltunc Emrullah, Cetin Mustafa
Department of Cardiology, Ankara Numune Education and Research Hospital, Turkey.
Case Rep Cardiol. 2016;2016:9126817. doi: 10.1155/2016/9126817. Epub 2016 Mar 27.
An 83-year-old man, who underwent coronary artery bypass operation of left internal mammary artery (LIMA) to left anterior descending (LAD) artery, with sequential saphenous vein to the first and second obtuse marginal (OM) branches of circumflex artery 5 years ago and coronary artery stent implantation to right coronary artery 2 months ago, was admitted to the hospital with syncope and chest pain. Aortosaphenous graft selective angiography revealed that first sequential side to side ligation was inadvertently anastomosed to left posterolateral coronary vein with resultant flow into the coronary sinus and distal end to side sequential anastomosis to OM 2 coronary artery which was filling very weakly. In order to close this iatrogenic coronary arteriovenous fistula and to supply saphenous vein flow to OM artery, we decided to implant a graft covered stent into the saphenous vein at the same session.
一名83岁男性，5年前接受了左乳内动脉（LIMA）至左前降支（LAD）动脉的冠状动脉搭桥手术，大隐静脉依次与回旋支动脉的第一和第二钝缘支（OM）吻合，2个月前接受了右冠状动脉冠状动脉支架植入术，因晕厥和胸痛入院。主动脉-大隐静脉移植选择性血管造影显示，首次连续侧侧吻合无意中与左后外侧冠状静脉吻合，导致血流进入冠状窦，远端端侧连续吻合至OM 2冠状动脉，充盈非常微弱。为了闭合这种医源性冠状动脉瘘并将大隐静脉血流供应至OM动脉，我们决定在同一次手术中在大隐静脉内植入带膜支架。
