Zhu J, Xu Z, Zhang B
Changhai Hospital, Second Military Medical University, Shanghai.
Zhonghua Wai Ke Za Zhi. 1995 Oct;33(10):618-20.
This paper reported four cases of acute coronary artery occlusion occurred during valve replacement procedure. Case 1 was of Marfan's syndrome who underwent Cabrol procedure. Case 2 was of congenital aortic bileaflet malformation with severe regurgitation and simple right coronary artery, who received the procedure of AVR. Both cases 3 and 4 suffered from rheumatic valve disease who were given DVR and tricuspid valve annuloplasty. All the cases had acute left coronary artery occlusion and did not revive after removal of aortic cross-clamp, which were immediately corrected by coronary bapass grafts from aortic to left descending branch with saphonous veins. All the patients successfully weaned from asistant circulation. Two cases survived. The causes of acute coronary artery occlusion were analyzed and the diagnostic methods and management introduced.
本文报道了4例在瓣膜置换手术过程中发生急性冠状动脉闭塞的病例。病例1为马方综合征，接受了卡布罗尔手术。病例2为先天性主动脉双叶畸形伴严重反流且仅有右冠状动脉，接受了主动脉瓣置换术。病例3和病例4均患有风湿性瓣膜病，接受了双瓣膜置换术和三尖瓣环成形术。所有病例均发生急性左冠状动脉闭塞，在移除主动脉阻断钳后未能恢复心跳，随后立即通过大隐静脉将主动脉与左前降支进行冠状动脉搭桥术予以纠正。所有患者均成功脱离辅助循环。2例患者存活。分析了急性冠状动脉闭塞的原因，并介绍了诊断方法和处理措施。
