Department of Cardiothoracic and Vascular Surgery, Meenakshi Hospital, Thanjavur, India.
Department of Cardiothoracic and Vascular Surgery, Meenakshi Hospital, Thanjavur, India.
Heart Lung Circ. 2020 May;29(5):e43-e45. doi: 10.1016/j.hlc.2019.12.013. Epub 2020 Jan 30.
Identification of an intramyocardial left anterior descending artery remains challenging and many techniques have been proposed for its identification. The exposure technique depends on the surgeon's familiarity and experience with it, and inadvertent right ventricular perforation during exposure on off-pump surgery results in bleeding, which requires urgent cardiopulmonary support and repair. Inadequate repair may result in continued bleeding, closure of the left anterior descending artery, and myocardial infarction. We describe a sandwich technique using the native left anterior descending artery and the bypass graft to repair right ventricular perforation, avoiding closure of this main artery and preserving graft patency.
识别心肌内的左前降支仍然具有挑战性，已经提出了许多技术来识别它。暴露技术取决于外科医生对其的熟悉程度和经验，而在非体外循环手术中暴露时意外地刺穿右心室会导致出血，这需要紧急心肺支持和修复。修复不当可能会导致持续出血、左前降支关闭和心肌梗死。我们描述了一种使用原生左前降支和旁路移植来修复右心室穿孔的三明治技术，避免了主要动脉的关闭并保持了移植通畅。
