共查询到20条相似文献,搜索用时 578 毫秒
1.
Yuji Takeda Naoki Minato Yuji Katayama Tomoki Shimokawa 《The Japanese Journal of Thoracic and Cardiovascular Surgery》2005,53(1):42-45
Two successful cases of the surgical treatment for coronary artery aneurysm (non-Kawasaki disease) were reported. The first case had a saccular aneurysm on the left circumflex coronary artery (LCx) #14. Resection of the LCx aneurysm was performed subsequent to single vessel coronary artery bypass grafting (CABG) to the distal portion of LCx#14 under the cardioplegic cardiac arrest. The second case had aneurysms on both the left anterior descending artery (LAD) #7 (fusiform) and the LCx#11 (saccular). After double vessel CABG to LAD#7 and LCx#11, ligation or resection of two aneurysms was performed successfully. Postoperative courses have been uneventful with good angiographic results achieved. Since these surgical procedures demonstrated safety, the patients are expected to achieve a good long-term prognosis. 相似文献
2.
Yohsuke Yanase Akihito Ohkawa Ryosuke Numaguchi Hiroshi Sato Naomi Yasuda Yosuke Kuroda Ryo Harada Toshiro Ito Hirosato Doi Nobuyoshi Kawaharada 《Journal of cardiac surgery》2019,34(3):143-146
A 74‐year‐old man had undergone two‐vessel coronary artery bypass grafting (CABG), 19 years ago, with the left internal mammary artery (LITA) to the left anterior descending artery and the saphenous vein graft (SVG) to the posterior descending artery. In outpatient care, a thoracic aortic aneurysm was suspected by the chest X‐ray. In the computed tomography, appeared the distal arch aortic aneurysm, abdominal aortic aneurysm (AAA), and giant right coronary artery aneurysm (rCAA). The diameter of rCAA was 70 mm and it oppressed the right atrium and ventricle of the heart. The patient was referred to our hospital. After the initial treatment of distal arch aneurysm and AAA, surgical treatment for the rCAA was performed. The rCAA was resected completely and CABG with new SVG was performed without cardiopulmonary bypass. The histopathology of rCAA wall revealed that the etiology was an atherosclerotic change. The postoperative course was good, the oppressed right heart system was released and the hemodynamics of the tricuspid valve showed improvement. 相似文献
3.
Okada Y Doi K Meshii K Kono S 《Kyobu geka. The Japanese journal of thoracic surgery》2011,64(10):933-935
A 52-year-old man was admitted to our hospital with complaint of chest pain and abnormal electrocardiogram (ECG) findings showing ST depression in V2-V6. Coronary computed tomography (CT) and coronary arteriography (CAG) showed coronary artery aneurysm at #5 [left main trunk (LMT)] 20 mm, #11 [circumflex artery (Cx)] 8.3 mm, RV branch 4 mm, and severe stenosis at #5 and #11. Therefore, his chest pain was due to thromboembolism from coronary artery aneurysm. In the present case, Kawasaki disease was not diagnosed in childhood. Coronary artery aneurysms were rare in the elderly and were usually found in association with Kawasaki disease. Morphological evaluation findings strongly suggested that the coronary artery aneurysm were related to Kawasaki disease. Resection of coronary artery aneurysm and coronary artery bypass grafting [left internal thoracic artery (LITA) to #8 and saphenous vein graft (SVG): aorta (Ao) to #14] were successfully performed. We report a case of coronary artery aneurysms presumed to be due to childhood Kawasaki disease in an elderly man. 相似文献
4.
Shigeki Higashi Chiharu Enoki Takashi Matsubara 《General thoracic and cardiovascular surgery》2001,49(1):79-81
The patient was a 70-year-old male with a chief complaint of chest pain. Coronary angiography revealed a saccular aneurysm of 11 mm in diameter at the furcation of the left main coronary artery. Triple vessel disease was also seen. At surgery, it was judged that the risk to rupture of the aneurysm was high because the aneurysmal wall was very thin. Therefore, the blood flow into the aneurysm was blocked, and coronary artery bypass grafting was performed. In a pathological study on the aneurysmal wall, no atherosclerotic and no inflammatory changes were found, but acidic mucopolysaccharides were detected in the tunica media. Coronary aneurysms with coronary stenosis in the elderly have been reported to be arteriosclerotic without exception. Here we present this rare case of a left main coronary artery aneurysm with coronary stenosis in an old-aged patient, considered to be due to metabolic abnormalities in the smooth muscle cells. 相似文献
5.
Yamazaki S Yokoyama S Shingaki M Miyake T Koh E 《Kyobu geka. The Japanese journal of thoracic surgery》2008,61(2):157-160
The successful surgical treatment for a coronary artery aneurysm was reported. A 38-year-old female presented with angina pectoris due to right coronary artery stenosis. Angiography revealed a right coronary artery aneurysm and 90% stenosis at a site just proximal to the aneurysm, accompanied by the relatively large right ventricular (RV) branch originating from a mid portion of the aneurysm. Off-pump coronary artery bypass grafting (CABG) to the right coronary artery (RCA) #3, translocation of RV branch to RCA #3, and ligation of RCA proximal and distal to the aneurysm were successfully performed. Post-operative course had been uneventful with satisfactory angiographic results. Coronary translocation with CABG could be a treatment option for coronary artery aneurysms. 相似文献
6.
Yoshiya Ishikura Shigetoh Odagiri Akira Shimazu Daigo Hirao Hiroyuki Watanabe Kouichi Yano 《Surgery today》1992,22(2):176-179
Three patients were treated for coronary artery-pulmonary artery fistula. Each was asymptomatic due to a coronary artery fistula. There was one instance each of myocardial infarction, mitral stenosis and a large closed ruptured aneurysm including a thrombus. All the fistulas were comprised of several small plexiform arranged vessels. The left to right shunt ratio was approximately 8 per cent or less. A surgical operation was performed to close the drainage orifice of the fistulas through pulmonary arteriotomy under cardiopulmonary bypass in two patients while one patient underwent a ligation of a large abnormal vessel to the aneurysm followed by a resection of the aneurysm without cardiopulmonary bypass. A large saccular aneurysm of such fistulas is rare and a rupture of such an aneurysm is even more rare. The surgical management of coronary artery fistulas is also discussed herein. 相似文献
7.
Masakuni Kido Hideki Kawaguchi Hideki Ninomiya Motohiko Osako Hajime Otani Hiroji Imamura 《General thoracic and cardiovascular surgery》1998,46(10):1024-1027
Aneurysm of the diverticulum of the ductus arteriosus in the adult is rare. One stage operation for aneurysm of the diverticulum of the ductus arteriosis and coronary artery bypass grafting (CABG) is reported. A 61-year-old man was admitted for diagnosis of thoracic aneurysm on chest X-ray and CT. Chest CT scan showed an aneurysm above the left main pulmonary artery. An aortography showed the left vertebral artery originated directly from the aortic arch and a saccular aneurysm arising from the aortic isthmus and lesser curvature of the aortic arch. Coronary arteriography showed 75% stenosis at the right coronary artery (seg. #1) and 75% stenosis at the left anterior descending artery. Operation was performed through a median sternotomy. The aneurysm of 6 to 3 cm was located between the aortic isthmus and left pulmonary artery. Ascending aorta and right atrium were used to institute cardiopulmonary bypass (CPB). CABG (LITA to #7, SVG to #4 PD) was performed. Arterial cannulation was then switched to the left femoral artery. The proximal aorta was cross-clamped between the left vertebral artery and the left subclavian artery under the partial CPB, and the distal aorta was occluded with a occulusive balloon catheter via the right femoral artery. The selective left axillar artery cannulation was performed to perfuse LITA. The aneurysm was resected and closed with a patch. His post-operative course was uneventful. 相似文献
8.
Azumi Hamasaki Tetsuro Uchida Yoshinori Kuroda Ai Ishizawa Mitsuaki Sadahiro 《Journal of cardiac surgery》2019,34(5):359-362
Here we report a rare case of atypical Kawasaki disease (KD) in a patient presenting with systemic arteritis affecting the coronary arteries, brain, and internal mammary arteries (IMAs). A 25‐year‐old man was referred to our institute with angina pectoris. Coronary angiography revealed coronary artery aneurysms and triple‐vessel disease. Three‐dimensional brain computed tomography showed multiple small saccular aneurysms on the vertebral and posterior inferior cerebellar arteries. Off‐pump coronary artery bypass (OPCAB) grafting ??????was performed; however, the bilateral IMAs were tightly adhered and not patent. OPCAB was completed using the bilateral radial and gastroepiploic arteries. This is the first report of KD involving the IMA. 相似文献
9.
S Higashi C Enoki T Matsubara 《The Japanese Journal of Thoracic and Cardiovascular Surgery》2001,49(1):79-81
The patient was a 70-year-old male with a chief complaint of chest pain. Coronary angiography revealed a saccular aneurysm of 11 mm in diameter at the furcation of the left main coronary artery. Triple vessel disease was also seen. At surgery, it was judged that the risk to rupture of the aneurysm was high because the aneurysmal wall was very thin. Therefore, the blood flow into the aneurysm was blocked, and coronary artery bypass grafting was performed. In a pathological study on the aneurysmal wall, no atherosclerotic and no inflammatory changes were found, but acidic mucopolysaccharides were detected in the tunica media. Coronary aneurysms with coronary stenosis in the elderly have been reported to be arteriosclerotic without exception. Here we present this rare case of a left main coronary artery aneurysm with coronary stenosis in an old-aged patient, considered to be due to metabolic abnormalities in the smooth muscle cells. 相似文献
10.
BACKGROUND: A persistent primitive hypoglossal artery (PPHA) is a rare anomaly. The association of PPHA with intracranial aneurysms of the artery has also been rarely reported. We surgically treated a case of PPHA associated with a ruptured saccular aneurysm at the proximal posterior inferior cerebellar artery (PICA). CASE DESCRIPTION: The patient was admitted because of subarachnoid hemorrhaging. Angiography and three-dimensional computed tomography (CT) angiography (3D-CTA) demonstrated a left PPHA entering the posterior fossa through the left large hypoglossal canal. The left vertebral artery was absent. A saccular aneurysm was found at the junction of the PPHA and the proximal PICA. 3D-CTA showed not only the aneurysm itself but also the anatomical relationship between the aneurysm and the surrounding structures. Therefore, 3D-CTA was very useful in planning the surgery. The neck of the aneurysm was clipped through a far lateral approach associated with a C1 laminectomy, because this case had a large posterior condylar emissary vein and the aneurysm was located just posteroinferior to the hypoglossal canal. CONCLUSIONS: A case of PPHA associated with an aneurysm at the proximal PICA is reported. This case not only had a large hypoglossal canal but also had a huge posterior condylar emissary vein in the large posterior condylar canal. Anomalous structures associated with PPHA are also discussed. Finally, 3D-CTA proved to be very useful in planning the optimal surgical modality around the lateral portion of the foramen magnum. 相似文献
11.
Masanao Okumori Shinichi Tokuno Yashiro Nogami Ichiro Kann Yoshiaki Tanaka 《Surgery today》1995,25(4):373-377
We report herein the case of a 22-year-old man with a history of Kawasaki disease who developed a giant calcified aneurysm of the left main coronary artery. The aneurysm was successfully resected and coronary bypass surgery was performed using the bilateral internal thoracic arteries. The resected aneurysm, the maximal diameter of which was 27 mm, showed heavy calcification of the inner layer and extended into the adjacent coronary arteries, producing a significant narrowing of the lumen of both the left main trunk (50%) and the anterior descending branch (50%). Extensive intimal calcification presumably prevented normal luminal development and produced a significant narrowing as the patient grew into adulthood. A cause for stenotic lesions developing in the coronary artery adjacent to a coronary aneurysm in adults with a history of Kawasaki disease is suggested here by the resected aneurysm seen in this patient. Thus, adult patients with giant coronary artery aneurysms and significant stenotic lesions of the coronary artery associated with Kawasaki disease may require aneurysmectomy in addition to bypass surgery. 相似文献
12.
Sekine Y Kitano M Akimoto T Matsuda K 《Kyobu geka. The Japanese journal of thoracic surgery》2007,60(13):1137-1141
Coronary artery fistulae are relatively rare congenital anomalies. Those associated with saccular coronary artery aneurysms are even rarer. Including the current case, only 65 such cases have been reported in Japan. A 62-year-old female was admitted to our hospital for evaluation of abnormal shadow on the chest X-ray. The enhanced chest computed tomography (CT) scan demonstrated a giant saccular coronary aneurysm on the left side of the pulmonary artery. Multi-detector row CT (MDCT) scan demonstrated the coronary artery aneurysm was connected to the left anterior descending artery. Coronary angiography revealed 2 aneurysms with bilateral coronary artery to pulmonary artery fistulae. The patient underwent aneurysmectomy and ligation of fistulae under cardiopulomonary bypass. The postoperative course was uneventful and postoperative coronary angiography revealed complete resection of the aneurysms and only slight blood flow through the fistulae. She was discharged on the 10th postoperative day. 相似文献
13.
In spite of the belief that pericallosal bifurcation is the predilectional site for aneurysm, only a few reports have so far
been available. Since 1963 nine cases of such aneurysms have been encountered at the Yamaguchi University Hospital. All aneurysms
located on so-called pericallosal bifurcation at the genu of the corpus callosum. Seven aneurysms were saccular and two were
fusiform. Multiple aneurysms were found in one case, while another case had a combined arteriovenous malformation at the periphery
of the aneurysm. In one case, the internal carotid artery on the opposite side was occluded.
Seven of the 9 patients were treated surgically. Ligation of the afferent artery was performed in the case with combined arteriovenous
anomaly. Direct attack to the aneurysm was safely done in the remaining 6 cases through interhemispheric approach, neck clipping
in 3 cases and adhesive coating in 3. Postoperative results were excellent in all cases but one, in which postoperative meningitis
developed.
In view of the disastrous outcome of pericallosal aneurysm when left alone, we believe that the direct surgical attack is
the treatment of choice. Fortunately, an aneurysm at this site can be handled easier and safer than deep seated aneurysms
in connection with Willis's circle, since it can be approached by interhemispheric route. 相似文献
14.
M Shigemori K Nakayama Y Oshima O Nakashima M Watanabe S Kuramoto 《No shinkei geka. Neurological surgery》1986,14(2):189-194
The authors describe two pairs of siblings and a mother-son with cerebral aneurysms and the characteristics of familial intracranial aneurysms are briefly discussed. Family 1: A 54-year-old hypertensive woman (case 1) developed subarachnoid hemorrhage and a saccular aneurysm at the proximal portion of the left anterior cerebral artery was demonstrated on the angiogram. An azygos anterior cerebral artery was found as an associated anomaly. A 53-year-old hypertensive woman (case 2), a younger sister of case 1, suffered from subarachnoid hemorrhage and a saccular aneurysm at the distal portion of the right anterior cerebral artery was found on the angiogram. Vertebral angiogram showed bilateral fenestration of the extracranial vertebral arteries as a coincidental anomalies. Neck clipping for the aneurysms were successfully done in these two cases. Family 2: A 52-year-old hypertensive woman (case 3) suffered from subarachnoid hemorrhage and vertebral angiogram demonstrated a saccular aneurysm at the distal portion of the right posterior inferior cerebellar artery. The aneurysm was re-bled before surgical intervention and she died five days after admission. A 65-year-old hypertensive woman (case 4), an elder sister of case 3, was admitted with subarachnoid hemorrhage. Vertebral angiogram showed a saccular aneurysm on the proximal portion of the left posterior inferior cerebellar artery at the junction of the vertebral artery and a massive extravasation of the contrast medium from the aneurysm. The patient died three days after the onset before surgical intervention.(ABSTRACT TRUNCATED AT 250 WORDS) 相似文献
15.
Taniyasu N Akiyama K Iba Y Hirota J 《Kyobu geka. The Japanese journal of thoracic surgery》2001,54(5):408-410
Graft replacement for arch aneurysms and concomitant coronary artery bypass grafting (CABG) were performed in four consecutive patients over a three-year period between March 1995 and October 1998. The etiology of the aneurysms was atherosclerosis in all the patients. One early death as a result of a cerebellar infarction occurred on the 74th postoperative day. In all cases, respiratory failure frequently occurred after surgery. In a recent case, the internal mammary artery was used as a graft conduit to the left anterior descending artery (LAD). Both artery and vein grafts were anastomosed to coronary arteries during the initial core cooling. Selective cerebral perfusion was carried out during the reconstruction of the transverse aortic arch and its branches. The left subclavian artery was anastomosed first to secure perfusion to the LAD. To achieve sufficient myocardial protection and obtain good postoperative hemodynamics, CABG was simultaneously performed at the time of aortic aneurysm repair in cases complicated with coronary artery disease. 相似文献
16.
心血管手术同期施行冠状动脉搭桥 总被引:13,自引:1,他引:12
为提高心血管手术同期施行冠状动脉搭桥(CABG)的疗效,降低手术死亡率,作者于1984年11月至1996年7月施行此类手术51例,其中瓣膜手术45例,室间隔穿孔和室壁瘤切除4例,左房粘液瘤摘除术和腹主动脉瘤切除术各1例。术后早期死亡3例,死亡率5.88%(1990年以后为4.17%),晚期死亡3例。作者认为:50岁以上或有心绞痛症状和心电图缺血依据的心血管外科患者,应常规行冠状动脉造影。对狭窄程度>50%的主要分支,在纠正其他心血管病变同时,须行CABG。术中充分再血管化,注意心肌保护,尽量减少升主动脉阻断时间。 相似文献
17.
Subclavian artery aneurysms are extremely rare, accounting for approximately 0.1% of peripheral artery aneurysms. We present a case of a proximal left subclavian arterial aneurysm in a patient status post previous coronary artery bypass grafting; the aneurysm was complicated by involvement of the left internal mammary artery that had been previously utilized to revascularize the left anterior descending artery. Ostial stenosis of the internal mammary artery secondary to the aneurysm was present. Simultaneous reoperative coronary bypass surgery and repair of the left subclavian aneurysm was performed, with a good result. This is the second case reported in the literature of concomitant subclavian artery aneurysm repair and coronary revascularization. 相似文献
18.
非体外循环和体外循环冠状动脉旁路移植术在二次冠状动脉旁路移植术中的应用 总被引:1,自引:1,他引:0
目的研究对比在二次冠状动脉旁路移植术(re-CABG)患者中分别采用非体外循环和体外循环下冠状动脉旁路移植术(off-pump CABG和on-pump CABG)的临床早期结果,探讨通过合理手术方式的选择,提高re-CABG的手术疗效。方法自2000年4月到2006年6月,21例首次CABG后因心绞痛复发患者在阜外心血管病医院接受了re-CABG手术,其中10例行off-pump CABG(off-pump组),11例行on-pump CABG(on-pump组)。两组患者术前性别、年龄、体重、心肺功能、心绞痛程度、左心室舒张期末内径、射血分数、合并高血压、糖尿病等方面差异无统计学意义(P>0.05)。结果 On-pump组中患者术后死亡1例,冠状动脉远端吻合口数多于off-pump组(P<0.05);off-pump组无手术死亡,在手术时间、术后呼吸机辅助时间、胸腔引流液量、输血量和手术后住院时间等方面,均明显少于on-pump组(P<0.05)。结论 Off-pump CABG和on-pump CABG技术在re-CABG中都可以取得满意疗效,off-pump CABG下施行re-CABG安全可靠。 相似文献
19.
Hideaki Mori Yoshitaka Okamura Yoshihiko Mochizuki Hiroshi Iida Yasuyuki Yamada Kunihiro Eda Yuho Inoue Shinichiro Miyoshi 《Annals of thoracic and cardiovascular surgery》2005,11(2):128-131
Brachiocephalic artery aneurysm with concomitant coronary artery aneurysm is rare. We describe a case of a patient with a history of prosthetic graft placement following resection of an abdominal aortic aneurysm and was subsequently found to have a brachiocephalic artery aneurysm. After surgical correction of the brachiocephalic aneurysm, postoperative coronary arteriography demonstrated coronary artery aneurysms, and the patient subsequently underwent coronary artery bypass grafting (CABG). 相似文献
20.
Masaru Yoshikai Masakatsu Hamada Kyoumi Takarabe 《The Japanese Journal of Thoracic and Cardiovascular Surgery》2004,52(8):379-382
Coronary artery aneurysms rarely develop in patients with systemic lupus erythematosus. We herein describe a case of a right
coronary artery aneurysm associated with systemic lupus erythematosus. A 49-year-old woman with known systemic lupus erythematosus
presented with an acute myocardial infarction. A coronary artery aneurysm and thrombo-occlusion in the right coronary artery
necessitated percutaneous coronary intervention. She experienced three myocardial infarctions during the following two months.
A coronary artery dissection occurred during the percutaneous coronary intervention at the time of the last myocardial infarction,
and emergency coronary artery bypass grafting was successfully performed. Difficulties in treatment with percutaneous coronary
intervention and the fact that arteritis is a possible cause of a coronary artery aneurysm may indicate that surgical therapy,
including coronary artery bypass grafting with or without the obliteration of an aneurysm, is the treatment of choice for
a coronary artery aneurysm with systemic lupus erythematosus. 相似文献