Coronary artery bypass grafting in a patient with hypertrophic non-obstructive cardiomyopathy. A case report.

VernacularTitle:肥大型非閉塞性心筋症に合併した冠動脈狭窄に対するＡＣバイパスの１治験例
Author: Hideki NAKAHARA ; Takashi YAMADA ; Yoshihito IRIE ; Motoki YOKOYAMA ; Nagahisa OHSHIMA ; Sadao TANABE
Publication Type:Journal Article
From:Japanese Journal of Cardiovascular Surgery 1990;19(4):595-599
CountryJapan
Language:Japanese
Abstract: Preoperatively, hypertrophic non-obstructive cardiomyopathy with asymmetrical septal hypertrophy was found in a 66-year-old man with a chief complain of effort angina whose CAG showed stenosis of 70% in LCA (seg 5) and 100% in RCA (seg 1) with collaterals from LAD. Although graft flows, 240ml to LAD and 28ml/min to RCA, were obtained, it was necessary to place the patient on the assisted circulation and catecholamines when the weaning from CPB was being tried due to “stone heart” despite patient had been on IABP during surgery and short anoxic arrest time of 44min. Postoperative hemodynamic recovery was slow with low cardiac output improved lately by the continuous use of IABP and DBcAMP. Catecholamines and vasodilators often cause disturbance of hemodynamics in hypertrophic obstructive type but seem to be effective in non-obstructive type. Importance of myocardial protection, use of IABP, careful administration of β-stimulants and DBcAMP are discussed in surgery of patients with cardiomyopathy.