Two cases of off-pump coronary artery bypass grafting combined with abdominal aortic aneurysm repair.
Two cases of off-pump coronary artery bypass grafting combined with abdominal aortic aneurysm repair.
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非体外循环冠状动脉搭桥术联合腹主动脉瘤修复术二例
DOI：
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发表时间：
2001
期刊：
影响因子：
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通讯作者：
M. Seki
中科院分区：
文献类型：
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作者：
S. Tabata;Y. Tomita;M. Tsubota;M. Seki
对2例冠心病合并腹主动脉瘤患者行非体外循环冠状动脉旁路移植术联合腹主动脉瘤修补术。第一名患者是一名67岁的男性，腹部有大的搏动性肿块。腹部计算机断层扫描显示有一个9厘米的动脉瘤，冠状动脉造影显示钝缘分支狭窄90%，无法进行经皮腔内血管成形术。他接受了同期单冠状动脉旁路移植术，没有心肺转流，分叉移植物置换。第二位病人是一位71岁的男性，他患有急性心肌梗塞，一个月后接受冠状动脉造影，发现冠状动脉中有三支血管病变。计算机断层扫描显示一个4厘米的动脉瘤，血管造影显示左肾动脉狭窄90%。他接受了一期手术，包括三次冠状动脉旁路移植术（无体外循环）、直型移植物置换术和使用隐静脉移植物重建左肾动脉。两例患者的术后病程均顺利。我们目前推荐一种包括非体外循环冠状动脉旁路移植术的单阶段手术。
Two cases of coronary artery disease coexisting with abdominal aortic aneurysm were treated with off-pump coronary artery bypass grafting combined with repair of the aneurysm. The first patient was a 67-year-old man exhibiting a large pulsating abdominal mass. Abdominal computed tomography demonstrated a 9-cm aneurysm and coronary angiogram revealed a 90% stenosis of the obtuse marginal branch for which percutaneous transluminal angioplasty could not be performed. He underwent simultaneous single coronary artery bypass grafting without cardiopulmonary bypass, and bifurcated graft replacement. The second patient was a 71-year-old man who had acute myocardial infarction, and one month later underwent coronary angiogram which revealed three vessel disease in the coronary artery. Computed tomography revealed a 4-cm aneurysm, and angiography showed a 90% stenosis of the left renal artery. He underwent a single stage operation that involved three coronary artery bypass grafting without cardiopulmonary bypass, straight graft replacement, and reconstruction of the left renal artery using the saphenous vein graft. The postoperative course was uneventful in both cases. We currently recommend a single stage operation involving off-pump coronary artery bypass grafting.