Ganta Srujan, Kavarana Minoo
1 Division of Cardiothoracic Surgery, Department of Surgery, Medical University of South Carolina Children's Hospital, Medical University of South Carolina, Columbia, SC, USA.
World J Pediatr Congenit Heart Surg. 2019 May;10(3):351-354. doi: 10.1177/2150135118825265.
We describe our management of a 2-year-old patient with Kawasaki disease with a giant proximal right coronary artery (RCA) aneurysm and a >99% RCA ostial stenosis. After median sternotomy and cardioplegic arrest of the heart, we opened the aorta and cut into the RCA ostium past the stenosis and giant aneurysm. The RCA was reconstructed with an autologous pericardial patch. Cross-clamp and cardiopulmonary bypass times of 84 minutes and 114 minutes, respectively, were required. Our approach avoids mammary harvesting and grafting in such small patients while successfully treating ischemia and hopefully prevents further aneurysmal dilation over time.
我们描述了对一名2岁川崎病患者的治疗过程，该患者患有巨大的右冠状动脉近端动脉瘤且右冠状动脉开口狭窄超过99%。在正中胸骨切开术和心脏停搏后，我们打开主动脉，切开狭窄部位及巨大动脉瘤远端的右冠状动脉开口。使用自体心包补片重建右冠状动脉。分别需要84分钟的主动脉阻断时间和114分钟的体外循环时间。我们的方法避免了在如此小的患者身上取乳内动脉并进行移植，同时成功治疗了缺血，有望防止动脉瘤随时间进一步扩张。
