Department of Cardiac Surgery, University Hospital of Antwerp, Edegem, Belgium.
Department of Cardiology, University Hospital of Antwerp, Edegem, Belgium.
Ann Thorac Surg. 2019 Aug;108(2):e91-e93. doi: 10.1016/j.athoracsur.2018.12.035. Epub 2019 Jan 23.
Left main coronary artery (LMCA) aneurysm is a very rare condition that usually requires surgical treatment. Although there is no consensus on the standard surgical technique, aneurysmal ligation with coronary artery bypass grafting is commonly used. This report presents a case of a giant LMCA aneurysm for which an alternative surgical approach was performed. The aneurysm was incised and partially resected. An interposition right internal thoracic artery graft from the LMCA to the left circumflex coronary artery was placed together with a left internal thoracic artery and free right internal thoracic artery graft. Postoperative imaging showed good patency of all grafts. This case demonstrates an effective approach for the surgical treatment of LMCA aneurysm that offers an alternative when other techniques are not desirable.
左主干冠状动脉（LMCA）动脉瘤是一种非常罕见的情况，通常需要手术治疗。虽然对于标准的手术技术尚无共识，但常采用冠状动脉旁路移植术进行动脉瘤结扎。本报告介绍了一例巨大的 LMCA 动脉瘤，采用了替代手术方法。切开并部分切除了动脉瘤。在 LMCA 至左回旋支之间放置了一个来自右内乳动脉的间置移植物，同时使用了左内乳动脉和游离右内乳动脉移植物。术后影像学显示所有移植物均通畅良好。该病例展示了一种治疗 LMCA 动脉瘤的有效手术方法，当其他技术不可行时，提供了一种替代方法。
