Monteiro João Pedro, Costa Sara Simões, Paulo Nelson Santos, Pereira Rodolfo
Cardiothoracic Surgery Centro Hospitalar de Vila Nova de Gaia/Espinho Vila Nova de Gaia Portugal.
Clin Case Rep. 2020 Dec 16;9(1):34-36. doi: 10.1002/ccr3.3384. eCollection 2021 Jan.
A 56-year-old woman entered the emergency department due to worsening dyspnea. Severe mitral regurgitation and pulmonary artery dilation with flow compatible with fistula were observed by transthoracic and transesophageal echocardiography. The patient had history of an ALCAPA (anomalous left coronary artery from pulmonary artery) syndrome having undergone coronary artery bypass grafting (saphenous venous graft to left anterior descending artery) 30 years before. Coronary angiography and computed tomography revealed patency of the graft, with the dilated vein running across the front of the ascending aorta and being responsible for the perfusion of the left anterior descending artery and circumflex artery. We resent this case for discussion of which surgical strategy/options are available in order to treat the mitral valve and avoid injuring the patent graft.
一名56岁女性因呼吸困难加重进入急诊科。经胸和经食管超声心动图检查发现严重二尖瓣反流以及肺动脉扩张且血流与瘘管相符。该患者有左冠状动脉起源于肺动脉（ALCAPA）综合征病史，30年前接受过冠状动脉搭桥术（大隐静脉移植至左前降支动脉）。冠状动脉造影和计算机断层扫描显示移植血管通畅，扩张的静脉横跨升主动脉前方，负责左前降支动脉和回旋支动脉的灌注。我们现将此病例提交讨论，以探讨治疗二尖瓣并避免损伤通畅移植血管的可用手术策略/方案。
