Harada H, Yamamoto N, Ueda M, Ichimiya Y, Komatsu S
Department of Thoracic and Cardiovascular Surgery, Hokkaido Perfectural Kushiro Hospital, Japan.
Kyobu Geka. 1996 Jul;49(7):557-61.
Reports on simultaneous revascularization operations for concomitant stenoses of the carotid and coronary arteries are many in Europe and America but few in Japan. Herein we report two cases of successful combined carotid endarterectomy and coronary artery bypass grafting. The first case was a 56-year-old male who had effort angina and a right carotid bruit with tinnitus. He was revealed to have severe stenosis of the right internal carotid artery as well as significant lesions of the right coronary artery. The second case was a 69-year-old male who had unstable angina and a left carotid bruit with a history of transient ischemic attack. Coronary angiography revealed three vessel disease and carotid digital subtraction angiography also revealed critical stenosis of the left internal carotid artery. In both cases, simultaneous carotid endarterectomy with an internal shunt and coronary artery bypass grafting were performed with a successful outcome. The use of internal shunt on reconstruction of the carotid artery was effective for protecting the brain.
关于同时进行颈动脉和冠状动脉狭窄的血管重建手术的报道在欧美很多，但在日本却很少。在此，我们报告两例成功的联合颈动脉内膜切除术和冠状动脉搭桥术的病例。第一例是一名56岁男性，有劳力性心绞痛、右颈动脉杂音伴耳鸣。检查发现他右颈内动脉严重狭窄以及右冠状动脉有明显病变。第二例是一名69岁男性，有不稳定型心绞痛、左颈动脉杂音并有短暂性脑缺血发作史。冠状动脉造影显示三支血管病变，颈动脉数字减影血管造影也显示左颈内动脉严重狭窄。在这两例中，均同时进行了带体内分流管的颈动脉内膜切除术和冠状动脉搭桥术，结果成功。在重建颈动脉时使用体内分流管对保护大脑有效。
