Matsuo Somei, Uchino Hideaki, Kim Cholus, Hirooka Shuto, Akabane Kentaro, Shimanuki Takao, Nishida Akiko
Department of Cardiovascular Surgery, Nihonkai General Hospital, Sakata, Japan.
Kyobu Geka. 2023 Feb;76(2):144-147.
Coronary artery aneurysms are rare and are often associated with atherosclerosis in adults and Kawasaki disease in children. Thromboembolism and rupture of the aneurysm are common complications associated with this condition. We report a case of coronary aneurysm resection and coronary artery bypass grafting (CABG) in a 36-year-old man with a history of recurrent acute myocardial infarction. There was no coronary aneurysms in first acute myocardial infarction. Histopathological examination of the resected coronary artery aneurysm wall revealed features of vasculitis, although the patient showed no episodes and physical findings of vasculitis. Coronary vasculitis can cause vascular endothelial cell injury and therefore requires careful follow-up.
冠状动脉瘤较为罕见，在成人中常与动脉粥样硬化相关，在儿童中常与川崎病相关。血栓栓塞和动脉瘤破裂是与此病症相关的常见并发症。我们报告一例36岁男性患者，有复发性急性心肌梗死病史，接受了冠状动脉瘤切除术和冠状动脉旁路移植术（CABG）。首次急性心肌梗死时并无冠状动脉瘤。对切除的冠状动脉瘤壁进行组织病理学检查显示有血管炎特征，尽管该患者未出现血管炎发作及体征。冠状动脉血管炎可导致血管内皮细胞损伤，因此需要密切随访。
