Nakamura Ken, Orii Kouan, Abe Takayuki, Haida Hirofumi
Cardiovascular Surgery, Saitama Cardiovascular and Respiratory Center, Kumagaya, Saitama, Japan
Cardiovascular Surgery, Saitama Cardiovascular and Respiratory Center, Kumagaya, Saitama, Japan.
BMJ Case Rep. 2020 Apr 23;13(4):e234203. doi: 10.1136/bcr-2019-234203.
Coronary aneurysm located just above the left main coronary artery (LMT) is rare and difficult to treat. How the aneurysm is accessed is very important as it determines the result of the surgery. A 70-year-old man with a large coronary aneurysm (40 mm in diameter) in the LMT underwent surgery to prevent its rupture; however, there was severe adhesion. Initially, dissection of the ascending aorta or the pulmonary artery seemed necessary to access the aneurysm; however, the process was possible with limited dissection between the ascending aorta and the pulmonary artery, and we succeeded in firmly closing the LMT site of entry.
位于左冠状动脉主干（LMT）上方的冠状动脉瘤罕见且治疗困难。如何进入动脉瘤非常重要，因为它决定了手术结果。一名70岁男性，其LMT处有一个大的冠状动脉瘤（直径40毫米），接受了预防动脉瘤破裂的手术；然而，存在严重粘连。最初，似乎需要解剖升主动脉或肺动脉才能进入动脉瘤；然而，通过在升主动脉和肺动脉之间进行有限的解剖，该过程得以完成，并且我们成功牢固地封闭了LMT的入口部位。
