Two cases of early occlusion of the internal thoracic artery graft after coronary bypass surgery

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概要

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• Case 1: An 80-year-old man was admitted because of exertional chest pain. Triple vessel disease was diagnosed from coronary angiography (CAG) results, and coronary bypass surgery was performed (the left and right internal thoracic arteries were anastomosed with the left anterior descending artery and left circumflex artery, respectively, and the gastroepiploic artery was anastomosed with the right coronary artery). CAG performed after recurrence of exertional chest pain showed occlusion of both the left and right internal thoracic artery graft. Thus, 3 years after the coronary bypass surgery, the internal thoracic artery graft showed occlusion. Case 2: A 73-year-old woman was admitted because of exertional chest pain. A stent was inserted because of severe stenosis from the left main trunk to the left descending artery. After stent insertion, the patient experienced unstable angina. CAG showed restenosis inside the stent. Thus, coronary bypass surgery was performed (left internal thoracic artery graft was anastomosed with the left descending artery, and saphenous vein graft was anastomosed with the left circumflex artery). CAG performed after recurrence of exertional chest pain showed occlusion of the left internal mammary artery graft. Thus, 1.5 years after the coronary bypass surgery, the internal thoracic artery showed occlusion. Cases 1 and 2 were considered to show different mechanisms in causing the early occlusion of the internal thoracic artery graft.

著者

• 田村 英俊

  立川相互病院循環器内科

• 田村 英俊

  立川相互病院

• 井上 友樹

  立川相互病院

• 新藤 英樹

  立川相互病院

• 大塚 信一郎

  立川相互病院循環器内科

• 井上 友樹

  立川相互病院循環器内科

• 稲葉 美紀

  立川相互病院循環器内科

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