妊娠相关性自发性冠状动脉夹层的手术病例。

A Surgical Case for Pregnancy-Related Spontaneous Coronary Artery Dissection.

机构信息

Department of Cardiac Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.

出版信息

Ann Thorac Surg. 2022 Feb;113(2):e115-e117. doi: 10.1016/j.athoracsur.2021.04.023. Epub 2021 Apr 20.

DOI:10.1016/j.athoracsur.2021.04.023

PMID:33891913

Abstract

The efficacy of coronary artery bypass grafting for pregnancy-related spontaneous coronary artery dissection (SCAD) is controversial, as graft occlusion due to SCAD lesion healing has been reported. Only 24 grafts in 14 cases of coronary artery bypass grafting for SCAD have been reported: 8 of the 9 arterial grafts were occluded, but 9 of the 15 vein grafts were patent. We encountered a case of coronary artery bypass grafting with left internal thoracic artery to the left antero-descending branch due to pregnancy-related SCAD. The patient's graft revealed good patency immediately postoperatively but string signs 7 months later due to healing of SCAD lesions.

摘要

冠状动脉旁路移植术治疗妊娠相关自发性冠状动脉夹层 (SCAD) 的疗效存在争议，因为据报道，SCAD 病变愈合会导致移植物闭塞。仅有 14 例妊娠相关 SCAD 行冠状动脉旁路移植术的报告中提到了 24 个移植物：9 个动脉移植物中有 8 个闭塞，但 15 个静脉移植物中有 9 个通畅。我们遇到了一例因妊娠相关 SCAD 而行左内乳动脉至左前降支的冠状动脉旁路移植术患者。患者术后即刻移植物通畅良好，但 7 个月后出现线样征，提示 SCAD 病变愈合。