Shibasaki I, Sugita Y, Okamura Y, Mochizuki Y, Iida H, Mori H, Yamada Y, Tabuchi K, Matsushita Y, Umezu H, Shimada K
Department of Thoracic Surgery, Dokkyo School of Medicine, Tochigi, Japan.
Kyobu Geka. 1997 Sep;50(10):874-7.
A rare case of aortic valve replacement (AVR) with poor left ventricular function, following coronary artery bypass grafting, was reported. The patient was 57-year-old man who received urgent CABG with 2 saphenous vein grafts 3 years ago. At that time, aortic regurgitation (AR) was grade 2. He suffered acute myocardial infarction 1 year after CABG because of the occlusion the saphenous vein graft to the obtuse marginal branch. Percutaneous transluminal angioplasty was successfully performed for occluded graft. Since then, however, AR increased gradually and the left ventricular function decreased. Three years after the initial operation, he was admitted again with congestive heart failure. Heart catheterization revealed grade 3 AR and 17% left ventricular ejection faction (LVEF). AVR was performed through a median sternotomy and 2 saphenous vein grafts were preserved. He showed uneventful postoperative recovery and is now very well with 40% LVEF.
报道了一例冠状动脉旁路移植术后左心室功能较差而行主动脉瓣置换术（AVR）的罕见病例。患者为一名57岁男性，3年前接受了紧急冠状动脉旁路移植术，使用了2条大隐静脉移植物。当时，主动脉反流（AR）为2级。冠状动脉旁路移植术后1年，他因钝缘支大隐静脉移植物闭塞而发生急性心肌梗死。对闭塞的移植物成功进行了经皮腔内血管成形术。然而，从那时起，主动脉反流逐渐增加，左心室功能下降。初次手术后3年，他因充血性心力衰竭再次入院。心导管检查显示主动脉反流为3级，左心室射血分数（LVEF）为17%。通过正中胸骨切开术进行了主动脉瓣置换术，并保留了2条大隐静脉移植物。他术后恢复顺利，目前左心室射血分数为40%，情况良好。
