Saga T, Shirotani H, Oku H, Yokoyama T, Shinohara T, Sunakawa A
Kyobu Geka. 1989 Jul;42(7):510-5; discussion 516-8.
Clinical problems in the surgical treatment for the vascular lesion after Kawasaki disease were evaluated in five patients who underwent myocardial revascularization. Each patient had significant stenosis or complete occlusion with aneurysmal formation. Four patients received single aortocoronary bypass and one patient received double bypass. Three saphenous veins and three internal mammary arteries were used for bypass grafting. There were no operative or late deaths. Three saphenous vein grafts and two internal mammary artery grafts were patent both in the early postoperative and in the late postoperative studies. Progression of the obstructive lesions at other coronary arteries which were not bypassed at the operation were found in two patients. One patient revealed bilateral common iliac aneurysms associated with progressive obstruction of urinary tract followed by renal dysfunction. It appears that even the patient who had satisfactory surgical results in late studies are required to be followed up with utmost care to other coronary lesions or other vascular lesions in addition to the lesions bypassed.
对5例接受心肌血运重建的川崎病血管病变外科治疗的临床问题进行了评估。每例患者均有明显狭窄或伴有动脉瘤形成的完全闭塞。4例患者接受了单根主动脉冠状动脉搭桥术，1例患者接受了双搭桥术。3条大隐静脉和3条胸廓内动脉用于搭桥移植。无手术死亡或晚期死亡。在术后早期和晚期研究中，3条大隐静脉移植物和2条胸廓内动脉移植物均通畅。在2例患者中发现了手术时未搭桥的其他冠状动脉阻塞性病变的进展。1例患者出现双侧髂总动脉瘤，伴有尿路进行性梗阻，随后出现肾功能障碍。看来，即使是在后期研究中手术结果令人满意的患者，除了搭桥病变外，还需要极其小心地随访其他冠状动脉病变或其他血管病变。
