Beckmann Erik, Rustum Saad, Marquardt Steffen, Merz Constanze, Shrestha Malakh, Martens Andreas, Haverich Axel, Ismail Issam
Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany.
Department of Interventional and Diagnostic Radiology, Hannover Medical School, Hannover, Germany.
J Card Surg. 2017 Nov;32(11):674-679. doi: 10.1111/jocs.13227. Epub 2017 Oct 13.
Coronary artery aneurysms (CAA) are rare. We present our experience with the surgical treatment of patients with CAAs.
Between March 2000 and October 2016, 15 patients with CAA underwent surgery.
Mean age of patients was 60 ± 16 years and 47% (n = 7) were male. Kawasaki syndrome was present in two (13%) patients and 7% (n = 1) patients had Marfan syndrome. Isolated CAAs were found in 73% (n = 11) and involvement of multiple vessels was present in 27% (n = 4) of patients. Coronary arteries (CA) affected by aneurysms were: 19% (n = 4) left main stem, 33% (n = 7) left anterior descending, 14% (n = 3) left circumflex, and 33% (n = 7) right coronary artery. The majority of patients (93%, n = 14) were operated on pump with a mean cross-clamp time of 51 ± 23 min. 53% (n = 8) of patients received total arterial CA bypass grafting, while the remaining patients (47%, n = 7) received venous ± internal thoracic artery grafts. Resection/ligation of CAA was performed in 27% (n = 4) of patients. In-hospital mortality was 0% (n = 0). Follow-up was complete for 100% of patients and comprised a total of 80 patient-years. During follow-up, only one patient (7%) required re-intervention.
Surgical treatment of CAA has good short- and long-term results.
冠状动脉瘤（CAA）较为罕见。我们介绍我们对CAA患者进行手术治疗的经验。
2000年3月至2016年10月期间，15例CAA患者接受了手术。
患者的平均年龄为60±16岁，47%（n = 7）为男性。2例（13%）患者患有川崎综合征，7%（n = 1）患者患有马凡综合征。73%（n = 11）的患者为孤立性CAA，27%（n = 4）的患者有多支血管受累。受动脉瘤影响的冠状动脉（CA）为：19%（n = 4）左主干，33%（n = 7）左前降支，14%（n = 3）左旋支，33%（n = 7）右冠状动脉。大多数患者（93%，n = 14）在体外循环下手术，平均阻断时间为51±23分钟。53%（n = 8）的患者接受了全动脉CA搭桥术，其余患者（47%，n = 7）接受了静脉±胸廓内动脉移植术。27%（n = 4）的患者进行了CAA切除/结扎术。住院死亡率为0%（n = 0）。100%的患者完成了随访，随访时间共计80患者年。在随访期间，只有1例患者（7%）需要再次干预。
CAA的手术治疗具有良好的短期和长期效果。
