Okamoto H, Yasuura K, Moriya H, Matsuura A, Ogawa Y, Seki A, Hirose S, Takeuchi E, Tanaka M, Abe T
Kokyu To Junkan. 1989 Jan;37(1):93-6.
A 66-year-old man, who had atrial septal defect (ASD) associated with severe coronary artery disease, underwent closure of ASD and concomitant coronary artery bypass grafting (LIMA-LAD & SVG-RCA). Response to surgery was excellent, with improvement of cardiac function and returning to NYHA functional class I, while, preoperatively, the patient had been limited due to symptoms related both to large left to right shunt flows (Qp/Qs 3.04) and to left ventricular dysfunction because of severe myocardial ischemia as well as previous inferior myocardial infarction. SAD is the most common form of congenital heart disease requiring surgery in adults, accordingly it should be remembered that some of the elderly patients with ASD might have obvious or occult coronary artery disease at the time of diagnosis and operative intervention.
一名66岁男性，患有房间隔缺损（ASD）并伴有严重冠状动脉疾病，接受了ASD封堵术及同期冠状动脉旁路移植术（左乳内动脉-左前降支及大隐静脉-右冠状动脉）。手术效果极佳，心脏功能改善，患者恢复至纽约心脏协会（NYHA）心功能I级，而术前患者因大量左向右分流（Qp/Qs 3.04）以及严重心肌缺血和既往下壁心肌梗死导致的左心室功能障碍所引起的症状而活动受限。房间隔缺损是成人需要手术治疗的最常见先天性心脏病形式，因此应记住，一些老年房间隔缺损患者在诊断和手术干预时可能存在明显或隐匿的冠状动脉疾病。
