Guo Qiao, Chen Yuan-Jing, Huang He
Department of Anesthesiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, People's Republic of China.
J Pain Res. 2019 Jul 16;12:2167-2176. doi: 10.2147/JPR.S200534. eCollection 2019.
Bland-White-Garland syndrome (BWGS) is a rare congenital coronary artery malformation. In adult patients with BWGS, left coronary artery is supplied by collateral vessels from dilated right coronary artery. When high-pressure coronary flow drains into the low-pressure pulmonary artery with little ventricle perfusion, it causes a "coronary steal". In this study, a 53-year-old man with untreated BWGS receiving choledochotomy under general anesthesia was presented. The patient suffered from chronic biliary calculi, atrial fibrillation, complete left bundle branch block, and chronic heart failure. The anesthetic management for choledochotomy in this patient presented a special challenge. Moreover, relevant literature search was performed for all the case reports of BWGS published in PubMed and MEDLINE from 1990 to 2018. In addition, a summary of underlying pathophysiology and anesthetic implications of patients with BWGS was provided.
布兰德-怀特-加兰综合征（BWGS）是一种罕见的先天性冠状动脉畸形。在成年BWGS患者中，左冠状动脉由扩张的右冠状动脉的侧支血管供血。当高压的冠状动脉血流排入低压的肺动脉而心室灌注很少时，就会导致“冠状动脉窃血”。在本研究中，报告了一名53岁未治疗的BWGS男性患者，在全身麻醉下接受胆总管切开术。该患者患有慢性胆结石、心房颤动、完全性左束支传导阻滞和慢性心力衰竭。该患者胆总管切开术的麻醉管理面临特殊挑战。此外，对1990年至2018年在PubMed和MEDLINE上发表的所有BWGS病例报告进行了相关文献检索。另外，还提供了BWGS患者潜在病理生理学及麻醉影响的总结。
