Yamamoto Taira, Endo Daisuke, Shimada Akie, Amano Atsushi
Department of Cardiovascular Surgery, Juntendo University, Tokyo, Japan.
SAGE Open Med Case Rep. 2021 Jun 18;9:2050313X211027749. doi: 10.1177/2050313X211027749. eCollection 2021.
Small saccular aneurysm in the right gastroepiploic artery is a sporadic disease accounting for approximately 0.4% of abdominal visceral aneurysms rarely observed during routine examination of other illnesses; however, it has been reported following rupture. The right gastroepiploic artery is a common alternative to the internal thoracic artery in coronary artery bypass grafting. We report a case of small aneurysms in the left anterior descending artery, diagonal branch artery, and right gastroepiploic artery and a pseudoaneurysm in right gastroepiploic artery. Coronary artery bypass grafting was performed using the left internal thoracic artery and right gastroepiploic artery, and a 5-mm aneurysm was observed in the right gastroepiploic artery. The resected 5-mm right gastroepiploic artery aneurysm was saccular. Pathological investigation revealed media loss and adventitial thinning, indicating the possibility of an aneurysm rupture. Thus, preoperative three-dimensional computed tomography is beneficial for patients with coronary arterial aneurysms and preoperative evaluation of right gastroepiploic artery to help achieve good clinical outcomes in patients undergoing coronary artery bypass grafting with another arterial aneurysm.
胃网膜右动脉小囊状动脉瘤是一种散发性疾病，约占腹部内脏动脉瘤的0.4%，在其他疾病的常规检查中很少见到；然而，已有破裂的报道。胃网膜右动脉是冠状动脉旁路移植术中胸廓内动脉的常用替代血管。我们报告一例左前降支动脉、对角支动脉和胃网膜右动脉小动脉瘤以及胃网膜右动脉假性动脉瘤的病例。使用左胸廓内动脉和胃网膜右动脉进行冠状动脉旁路移植术，在胃网膜右动脉中观察到一个5毫米的动脉瘤。切除的5毫米胃网膜右动脉动脉瘤为囊状。病理检查显示中膜缺失和外膜变薄，提示动脉瘤破裂的可能性。因此，术前三维计算机断层扫描对冠状动脉瘤患者有益，对胃网膜右动脉进行术前评估有助于在患有另一种动脉瘤的患者接受冠状动脉旁路移植术时取得良好的临床效果。
