僧帽弁狭窄症における冠動脈造影所見
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概要
- 論文の詳細を見る
The frequency of coronary artery disease combined with mitral stenosis (MS), the preoperative diagnostic value of selective coronary arteriography (CAG) for the left atrial thrombus and the characteristic findings of CAG were investigated in 30 patients with MS. Twenty five of them were underwent mitral valve replacement or mitral commissurotomy, and CAG were performed postoperatively. Ischemic changes in the electrocardiogram (ECG) were compared with the findings of CAG. Inspite of the ischemic patterns in ECG no stenotic coronary artery lesions were found in this series. With regard to the preoperative diagnosis of left atrial thrombus, CAG and two dimensional echocardiogram (UCT) were compared with operative findings. Twelve patients had fistulous communication to the left atrium, and six of them had the neovascularity in preoperative CAG. The left atrial thrombus was found at the operation in 8 patients and half of them had had both fistula and neovascularity preoperatively. After the removal of left atrial thrombus the neovascularity disappeared, but the fistula remained unchanged. For the preoperative diagnosis of left atrial thrombus the UCT was seemed to be more useful than the CAG, but the preoperative diagnosis of the left atrial thrombus will be made more accurately by the combined use of UCT and CAG. The tortuous coronary arteries were characteristic findings in the patients with MS. The reason of tortuosity was not known exactly.
- 神戸大学の論文