Izumoto H, Kitahara H, Ohhira K, Motegi I, Kawazoe K
Department of Cardiovascular Surgery, Kitakami Saiseikai Hospital, Japan.
Surg Today. 1998;28(4):438-40. doi: 10.1007/s005950050160.
A 58-year-old man with postinfarction unstable angina was referred to the Department of Cardiovascular Surgery at the Saiseikai Kitakami Hospital for urgent coronary revascularization. The bilateral internal thoracic arteries (ITAs) were subsequently utilized to revascularize the myocardium. The left anterior descending artery (LAD) was revascularized with the in situ right ITA and the obtuse marginal artery was revascularized with the in situ left ITA. Although he was successfully weaned from cardiopulmonary bypass, he collapsed hemodynamically 15 min later. Thus, he underwent supplementary vein bypass grafting to the distal LAD and the diagonal artery. Postoperatively, his course was uneventful, apart from the perioperative infarction, and a coronary arteriogram demonstrated patent bilateral ITAs and vein graft. This case report emphasizes the importance of early recognition of this rare syndrome and advocates surgical treatment consisting of supplementary vein grafting.
一名患有心肌梗死后不稳定型心绞痛的58岁男性被紧急转诊至西日本北上市立医院心血管外科，以进行紧急冠状动脉血运重建。随后使用双侧胸廓内动脉（ITA）对心肌进行血运重建。原位右ITA用于对左前降支动脉（LAD）进行血运重建，原位左ITA用于对钝缘支动脉进行血运重建。尽管他成功脱离了体外循环，但15分钟后出现血流动力学崩溃。因此，他接受了对LAD远端和对角支动脉的补充静脉搭桥手术。术后，除围手术期梗死外，他的病情平稳，冠状动脉造影显示双侧ITA和静脉移植物通畅。本病例报告强调了早期识别这种罕见综合征的重要性，并提倡采用补充静脉搭桥的手术治疗方法。
