Uchida N, Kawaue Y
Department of Cardiovascular Surgery, Hiroshima General Hospital, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1996 Aug;44(8):1136-40.
A 13-year-old girl performed two coronary artery bypass grafting with only left internal thoracic artery. She had no symptoms but was pointed out the abnormality in ECG (ST depression of V4 and V5) at junior high school. According to a coronary angiogram, she was diagnosed as double coronary vessels disease (a total occlusion on the proximal left anterior descending and a stenosis of 90% on the left high lateral artery). She performed sequential coronary artery bypass grafting to the left anterior descending artery and high lateral artery with only left internal thoracic artery. The anastomotic site on the left anterior descending artery showed slight thickness of the internal lumina and chronic inflammation. However they could not detect the pathological diagnosis. The postoperative course was uneventful. The postoperative angiographic control demonstrated a good patency with much blood flow of the left internal thoracic artery graft sequentially anastomosed to the left anterior descending artery and high lateral artery. The postoperative electrocardiogram became normal. She discharged on the 19th postoperative day. The sequential coronary artery bypass grafting with the left internal thoracic artery was effective for infantile ischemic heart disease.
一名13岁女孩仅使用左胸廓内动脉进行了两次冠状动脉搭桥手术。她没有症状，但在初中时心电图（V4和V5导联ST段压低）检查发现异常。根据冠状动脉造影，她被诊断为双冠状动脉疾病（左前降支近端完全闭塞，左高位外侧动脉狭窄90%）。她仅使用左胸廓内动脉对左前降支和高位外侧动脉进行了序贯冠状动脉搭桥手术。左前降支的吻合部位显示管腔内轻度增厚并伴有慢性炎症。然而，他们未能做出病理诊断。术后过程顺利。术后血管造影检查显示，序贯吻合至左前降支和高位外侧动脉的左胸廓内动脉移植物通畅良好，血流丰富。术后心电图恢复正常。她于术后第19天出院。左胸廓内动脉序贯冠状动脉搭桥术对小儿缺血性心脏病有效。
