Successful Two-stage Operation on a Case with Occluded Coronary Artery Bypass Grafting and Thoracic Aortic Aneurysm.
10.4326/jjcvs.25.42
- VernacularTitle:ＣＡＢＧ後２０年のグラフト閉塞と胸部大動脈りゅう合併例に対する２期的手術
- Author:
Akihiko Sasaki
;
Hirosato Doi
;
Kenji Sugiki
;
Takemi Ohno
- Publication Type:Journal Article
- From:Japanese Journal of Cardiovascular Surgery
1996;25(1):42-45
- CountryJapan
- Language:Japanese
-
Abstract:
A 57-year-old male had single bypass graft to the right coronary artery with a saphenous vein graft 20 years previously. He noticed recurrent anginal pain since 1991 and thoracic aortic aneurysm was also pointed out in 1993. Coronary angiography showed that the saphenous vein graft was occlusion, accompanied with the distal portion of the occluded anterior descending coronary artery perfused by collateral flow from the circumflexus branch. The left ventricular function was moderately impaired (EF=38%). Re-do of coronary artery bypass grafting was done to the AV branch of the right coronary artery with the right gastroepiploic artery and the primary sequential grafting to anterior descending coronary artery and diagonal branch with left internal thoracic artery. One month after CABG, graft replacement of descending thoracic aorta was done because of thoracic aortic aneurysm. The postoperative course was uneventful except for the complication of chylothorax after the second operation. Postoperative angiography showed good patency of the left internal thoracic artery and right gastroepiploic artery and no abnormality of the graft anastomosis.
