Uwabe K, Tsuchiya K, Sasaki H, Morishita A, Iida Y
Department of Cardiovascular Surgery, Yamanashi Prefectural Central Hospital, Kofu, Japan.
Kyobu Geka. 1996 Jan;49(1):73-5.
A 69-year-old man was referred to us with the diagnosis of abdominal aortic aneurysm (7 cm in diameter). Additionally his coronary arteriogram showed severe stenosis (LMT 75% and #6 99% delay). Because his ascending aorta was calcified severely, double CABG (LITA to LAD and RGEA to PL) was carried out in hypothermic ventricular fibrillation. Abdominal aortic aneurysm was replaced thereafter while the patient was still on cardiopulmonary bypass. His postoperative courses was satisfactory. In cases requiring early operation for both myocardial ischemia and abdominal aortic aneurysm, one stage operation was recommended. When atherosclerotic changes in the ascending aorta were severe, in situ arterial bypass grafting for ischemic heart disease under hypothermic ventricular fibrillation was useful.
一名69岁男性因腹主动脉瘤（直径7厘米）被转诊至我院。此外，他的冠状动脉造影显示严重狭窄（左主干75%，6号血管99%延迟）。由于他的升主动脉严重钙化，在低温心室颤动下进行了双冠状动脉旁路移植术（左内乳动脉至左前降支，右胃网膜动脉至后降支）。此后，在患者仍在体外循环时进行了腹主动脉瘤置换术。他的术后病程令人满意。对于心肌缺血和腹主动脉瘤均需要早期手术的病例，建议进行一期手术。当升主动脉的动脉粥样硬化改变严重时，在低温心室颤动下进行原位动脉旁路移植术治疗缺血性心脏病是有效的。
