Fukui T, Suehiro S, Shibata T, Sasaki Y, Minamimura H, Kinoshita H
Second Department of Surgery, Osaka City University, Osaka, Japan.
Surg Today. 1998;28(3):321-4. doi: 10.1007/s005950050131.
We report herein the case of an 80-year-old woman who underwent successful redo coronary artery bypass grafting (CABG) for a saphenous vein graft aneurysm found 10 years after her initial operation. On presentation, coronary angiography (CAG) revealed aneurysmal dilatation of the saphenous vein graft and severe stenosis of the left main trunk (LMT). A percutaneous transluminal coronary angioplasty (PTCA) of the LMT lesion was performed; however, a CAG after the PTCA revealed restenosis and the patient developed anginal chest pain at rest. Thus, repeat CABG was urgently carried out, which was followed by a good outcome. Histological examination of the aneurysmal dilatation showed a true aneurysm. Only 15 other cases of redo CABG for this indication have been reported, the features of which are also discussed.
我们在此报告一例80岁女性患者的病例，该患者在初次手术10年后因发现大隐静脉移植血管动脉瘤而成功接受再次冠状动脉旁路移植术（CABG）。就诊时，冠状动脉造影（CAG）显示大隐静脉移植血管呈瘤样扩张，左主干（LMT）严重狭窄。对LMT病变进行了经皮腔内冠状动脉成形术（PTCA）；然而，PTCA术后的CAG显示再狭窄，患者出现静息性心绞痛。因此，紧急进行了再次CABG，随后效果良好。对瘤样扩张进行组织学检查显示为真性动脉瘤。此前仅报道过另外15例因该适应证进行再次CABG的病例，本文也讨论了这些病例的特点。
