Landymore R W, Kinley C E, Murphy D A, Sullivan J A
Ann Thorac Surg. 1986 Mar;41(3):293-6. doi: 10.1016/s0003-4975(10)62772-5.
Neurological injury following myocardial revascularization may result from embolization of atheromatous debris from the diseased ascending thoracic aorta. Eight patients with calcified aortas who underwent elective myocardial revascularization suffered major strokes as a result of manipulation and clamping of the diseased ascending aorta during a 30-month period before July, 1981. computerized axial tomography scans demonstrated multiple cerebral infarctions in each patient. Six patients never regained consciousness and died as a result of neurological injury; 2 patients regained consciousness but were left with major neurological deficits. Later, 21 patients with calcific aortic degenerative disease underwent a specific operative protocol, designed to prevent neurological injury during elective myocardial revascularization. All 21 patients recovered without neurological complications. Specific attention to operative technique allowed this difficult group of patients with incapacitating angina and calcific degenerative aortic disease to have the benefit of coronary bypass.
心肌血运重建术后的神经损伤可能源于病变的升主动脉粥样硬化碎片的栓塞。1981年7月前的30个月期间，8例患有钙化主动脉的患者接受了择期心肌血运重建术，由于在手术中对病变的升主动脉进行操作和钳夹，导致了严重中风。计算机断层扫描显示每位患者均有多处脑梗死。6例患者未恢复意识，因神经损伤死亡；2例患者恢复意识，但遗留严重神经功能缺损。后来，21例患有钙化性主动脉退行性疾病的患者接受了特定的手术方案，旨在防止择期心肌血运重建术中的神经损伤。所有21例患者均康复，无神经并发症。对手术技术的特别关注使这组患有失能性心绞痛和钙化性退行性主动脉疾病的困难患者受益于冠状动脉搭桥术。
