Minamida Taro, Sugiki Takashi, Itou Masamichi, Kamikubo Yasuhiro, Takahira Makoto
Department of Cardiovascular Surgery, Kushiro City General Hospital, Kushiro, Japan.
Kyobu Geka. 2017 Sep;70(10):859-862.
Bland-White-Garland (BWG) syndrome (anomalous origin of the left coronary artery from the pulmonary artery) is a rare disease which may result in myocardial infarction, congestive heart failure or sometimes death during the early infantile period. We present a 57-year-old female with BWG syndrome. At the age of 20, she was diagnosed with BWG syndrome and underwent coronary artery bypass grafting of a saphenous vein to the proximal portion of the anterior descending branch of the left coronary artery and ligation of the anomalous artery. Thirty-seven years later, she presented with symptoms of angina pectoris and congestive heart failure. Coronary angiography (CAG) revealed stenosis of the saphenous vein graft. Bare metal stent implantation for the saphenous vein graft was performed, but at the 6 months' follow-up CAG revealed restenosis. Drug-eluting stent was then implanted, but in-stent restenosis recurred 4 months later. We performed off-pump coronary artery bypass grafting to the left anterior descending artery using the left internal thoracic artery. The postoperative course was uneventful.
布兰德-怀特-加兰（BWG）综合征（左冠状动脉起源于肺动脉异常）是一种罕见疾病，可能导致婴儿早期发生心肌梗死、充血性心力衰竭，有时甚至死亡。我们报告一例57岁患有BWG综合征的女性患者。20岁时，她被诊断为BWG综合征，并接受了将大隐静脉移植至左冠状动脉前降支近端以及结扎异常动脉的冠状动脉旁路移植术。37年后，她出现心绞痛和充血性心力衰竭症状。冠状动脉造影（CAG）显示大隐静脉移植血管狭窄。对大隐静脉移植血管进行了裸金属支架植入，但在6个月随访时CAG显示再狭窄。随后植入了药物洗脱支架，但4个月后支架内再狭窄复发。我们使用左胸廓内动脉对左前降支进行了非体外循环冠状动脉旁路移植术。术后过程顺利。
