Oda K, Hirose K, Fukutomi T, Nishimori H, Yamashiro T, Ogoshi S, Do Y
Department of 2nd Surgery, Kochi Medical School, Japan.
Kyobu Geka. 1995 Aug;48(9):785-7.
A case report of an operation after CABG and AVR was presented. The patient was a 52-year-old female. She underwent CABG with saphenous veins at 43 years old and AVR at 45 years old. She was admitted to our hospital due to acute myocardial infarction. Coronary angiography revealed that all the native coronary arteries were occluded at the proximal side, two grafts to RCA and CX were occluded, and LAD graft had a 99% stenosis. She became critically ill due to low cardiac output and acute renal failure. Endoartrectomy of the LAD graft was performed under CPB. Early postoperative course was uneventful. Severe ST depression in the pre-operative ECG normalized in the postoperative ECG. But she had a chest pain again in the 4th postoperative week. She became critically ill and died on the 43rd postoperative day. It was thought that redo CABG should have been performed after her condition improved.
本文报告了一例冠状动脉旁路移植术（CABG）和主动脉瓣置换术（AVR）后再次手术的病例。患者为一名52岁女性。她在43岁时接受了大隐静脉冠状动脉旁路移植术，45岁时接受了主动脉瓣置换术。她因急性心肌梗死入住我院。冠状动脉造影显示，所有自身冠状动脉近端均闭塞，两支右冠状动脉（RCA）和左旋支（CX）的移植血管闭塞，左前降支（LAD）移植血管有99%的狭窄。由于心输出量低和急性肾衰竭，她病情危重。在体外循环下对LAD移植血管进行了内膜切除术。术后早期过程顺利。术前心电图中严重的ST段压低在术后心电图中恢复正常。但她在术后第4周再次出现胸痛。她病情危重，于术后第43天死亡。有人认为，应在她病情好转后进行再次冠状动脉旁路移植术。
