Okugi Satoshi, Saito Hiroyuki, Umeda Etsuji, Takiguchi Yoji
Department of Pediatric Cardiac Surgery, Gifu Prefectural General Medical Center, Gifu, Japan.
Kyobu Geka. 2017 May;70(5):381-384.
Coronary artery aneurysm is rare, and there is no established protocol for surgical indication. On preoperative examination of orthopedic surgery, a 76-year-old male was found with asymptomatic myocardial ischemia. Radiological examinations revealed triple vessel disease and a coronary artery aneurysm, 10 mm in size, at the bifurcation of the left main trunk. Combined with quintuple coronary artery bypass grafting, surgical repair of the aneurysm was peformed under cardiopulmonary bypass on beating heart. Epicardial echocardiography was used to detect the site and the blood flow on the aneurysm. Postoperative course was uneventful. Epicardial echocardiography was useful for detecting the coronary artery aneurysm in the myocardium and the residual aneurysmal blood flow.
冠状动脉瘤较为罕见，目前尚无确定的手术指征方案。在骨科手术的术前检查中，发现一名76岁男性存在无症状性心肌缺血。影像学检查显示三支血管病变以及在左主干分叉处有一个大小为10毫米的冠状动脉瘤。联合进行冠状动脉搭桥术，在体外循环下心脏跳动时对动脉瘤进行了手术修复。采用心外膜超声心动图检测动脉瘤的部位和血流情况。术后过程顺利。心外膜超声心动图有助于检测心肌内的冠状动脉瘤以及残留的动脉瘤血流。
