Shibata T, Suehiro S, Kimura E, Nishizawa K, Minamimura H, Kinoshita H
Second Department of Surgery, Osaka City University Medical School, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1994 Jul;42(7):1105-7.
Coronary artery bypass grafting (CABG) in a patient who had undergone left pneumonectomy for lung cancer 13 years earlier is described. Preoperative pulmonary function was reduced; percent vital capacity was 55% and percent forced expiratory volume in 1 second was 77%. Triple CABG was performed with saphenous vein grafts. A retractor designed for use in harvesting of the internal thoracic artery was useful to obtain a good operative view because the heart had shifted to the left. Oxygen tension of the arterial blood decreased transiently after extracorporeal circulation. The early postoperative course was uneventful and the patient was discharged on day 57 after the operation. This is the first report, to the best our knowledge, of CABG after pneumonectomy for lung cancer in Japan. We think it possible, with careful management, to perform open heart surgery on a patient after pneumonectomy if pulmonary function is adequate.
本文描述了一名13年前因肺癌接受左肺切除术的患者接受冠状动脉旁路移植术（CABG）的情况。术前肺功能下降；肺活量百分比为55%，一秒用力呼气量百分比为77%。采用大隐静脉移植进行了三联CABG。由于心脏已向左移位，一种设计用于获取胸廓内动脉的牵开器有助于获得良好的手术视野。体外循环后动脉血氧张力短暂下降。术后早期过程平稳，患者于术后第57天出院。据我们所知，这是日本首例肺癌肺切除术后行CABG的报告。我们认为，如果肺功能足够，通过仔细管理，对肺切除术后的患者进行心脏直视手术是可行的。
