Ikeda M, Takahashi M, Sawa S, Tanaka N, Michishita I, Matsushita K, Kawasuji M, Watanabe Y
Department of Cardiovascular Surgery, Yokohama Sakae Kyosai Hospital, Japan.
Kyobu Geka. 1996 Nov;49(12):1005-7.
A 27-year-old female underwent concomitant aortic valve replacement and reconstruction of the right renal artery. She was diagnosed as aortitis syndrome with AR and 90% stenosis of the right renal artery by angiography. PRA were high, Ccr value was low, and renogram showed non-functioning pattern in the right kidney though normal pattern in the left. After CRP value was decreased by predonisolone, the operation was done in the inactive stage. Postoperative angiography showed good aortic valve function and patent renal artery graft. Postoperative PRA and Ccr became normal and the renogram was improved. Based on the result we recommended simultaneous operation can be done with minimal risk.
一名27岁女性接受了主动脉瓣置换术和右肾动脉重建术。她被诊断为大动脉炎综合征合并主动脉反流,血管造影显示右肾动脉狭窄90%。肾素活性升高,肌酐清除率降低,肾图显示右肾无功能,而左肾正常。在使用泼尼松龙使C反应蛋白值降低后,于病情静止期进行了手术。术后血管造影显示主动脉瓣功能良好,肾动脉移植血管通畅。术后肾素活性和肌酐清除率恢复正常,肾图改善。基于这一结果,我们建议可以在风险最小的情况下进行同期手术。