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ULTIMO FASCICOLOTHE JOURNAL OF CARDIOVASCULAR SURGERY

Rivista di Chirurgia Cardiaca, Vascolare e Toracica


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The Journal of Cardiovascular Surgery 1999 Agosto;40(4):535-8

CARDIAC PAPERS 

 CASE REPORTS

Sur­gical man­age­ment of arte­rio­scle­rotic cor­o­nary ­artery aneu­rysm

Shi­mizu T., Hirayama T., Koi­zumi N., Ish­i­maru S., Nakai H., Tsu­chida H.

From the Depart­ment of Sur­gery II Tokyo Med­ical University, ­Tokyo, ­Japan

A 60-­year-old man suf­fered ­antero-­septal myo­car­dial infarc­tion at the age of 56. Cor­o­nary angio­graphy dem­on­strated ­total occlu­sion of the ­left ante­rior ­descending ­artery and a ­large sac­cular aneu­rysm of the ­right cor­o­nary ­artery. Dif­fuse cor­o­nary ­ectasia was ­also ­shown in the ­right cor­o­nary ­artery adja­cent to the aneu­rysm. ­Despite anti­co­ag­u­lant ­therapy, the aneu­rysm ­formed a ­thrombus and devel­oped cor­o­nary ­artery sten­osis ­distal to the aneu­rysm. Liga­tion of the aneu­rysm and in ­situ gas­troep­i­ploic ­artery ­grafting ­were per­formed. ­Sudden ­heart ­failure was devel­oped ­during ­skin clo­sure. As ­this con­di­tion was con­sid­ered to be ­graft hypo­per­fu­sion, sup­ple­mental saph­e­nous ­vein ­grafting was ­placed. Liga­tion is a ­simple, reli­able tech­nique to pre­vent ­future com­pli­ca­tions for a ­large sac­cular ­right cor­o­nary ­artery aneu­rysm, how­ever, gas­troep­i­ploic ­artery ­might be an inap­pro­priate ­bypass con­duit for the ­ligated cor­o­nary ­artery ­with dif­fuse ­ectasia.

lingua: Inglese


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