[症例報告]右冠動脈、左冠動脈回旋枝完全閉塞を伴った重症左冠動脈主幹部病変の1手術例

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  • Surgical treatment of severe left main trunk disease with total occlusion of right coronary artery and left circumflex artery : A case report

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A 68-year-old man had complete occlusion of the proximal right coronary artery and left circumflex artery, 90% stenosis of the left main trunk and the proximal left anterior descending artery (LAD) (Seg.7). A preoperative left ventriculogram revealed anterolateral, apical hypokinesis and inferior akinesis. The left ventricular function was poor with an ejection fraction of 0.35. The patient underwent coronary artery bypass grafting to the distal LAD using the left internal thoracic artery(ITA) in situ and to the proximal LAD using a saphenous vein graft(SVG), simultaneously. Weaning from cardiopulmonary bypass was smoothly carried out without intra-aortic balloon pumping support. We performed simultaneous arterial bypass graft and vein bypass graft to LAD expecting a larger blood flow through the vein graft in the early postoperative stage and good long term survival with acceptable increase of blood flow. A postoperative angiogram indicated good function of ITAgraftand SVG29 days after the surgery. The patient is well and is socially active 11 months after the surgery.

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