Nakayama Taisuke, Nakayama Mayuko, Harada Takashi, Isshiki Shingo, Sasaki Hideki, Ishitoya Hiroshi
Department of Cardiovascular Surgery, Ehime Prefectural Central Hospital, Matsuyama, Japan.
SAGE Open Med Case Rep. 2019 Jan 22;7:2050313X18818724. doi: 10.1177/2050313X18818724. eCollection 2019.
Neurofibromatosis type 1, also called von Recklinghausen's disease, is a hereditary congenital disorder that affects tissues of neuroectodermal or mesodermal origin. This disease has various manifestations, including pigmented skin lesions, cutaneous neurofibromas, skeletal abnormalities, and tumors of the central/peripheral nervous and gastrointestinal systems, and vascular abnormalities. Because of vasculopathy, part of the vessel wall may be replaced by neurofibromatosis tissue. Involvement of the internal thoracic artery is, however, extremely rare. Off-pump coronary artery bypass grafting using the left internal thoracic artery was performed for coronary arterial disease in a patient with neurofibromatosis, and the residual left internal thoracic artery vessel pathology was investigated. The left internal thoracic artery vessel showed intimal proliferation, medial thinning, and fragmentation of elastic tissue. However, these findings were not typical for von Recklinghausen's neurofibromatosis. Internal thoracic artery graft selection was feasible for coronary artery bypass grafting in a patient with neurofibromatosis type 1.
1型神经纤维瘤病，也称为冯雷克林霍增氏病，是一种遗传性先天性疾病，会影响神经外胚层或中胚层起源的组织。这种疾病有多种表现，包括色素沉着性皮肤病变、皮肤神经纤维瘤、骨骼异常以及中枢/外周神经系统和胃肠道系统的肿瘤，还有血管异常。由于血管病变，部分血管壁可能被神经纤维瘤病组织替代。然而，胸廓内动脉受累极为罕见。我们对一名患有神经纤维瘤病的患者进行了使用左胸廓内动脉的非体外循环冠状动脉旁路移植术治疗冠状动脉疾病，并对残留的左胸廓内动脉血管病理进行了研究。左胸廓内动脉血管显示内膜增生、中层变薄以及弹性组织断裂。然而，这些表现并非典型的冯雷克林霍增氏神经纤维瘤病表现。对于1型神经纤维瘤病患者，选择胸廓内动脉进行冠状动脉旁路移植术是可行的。
