Left Coronary Ostial Stenosis after the Modified Bentall Using a Long Interposed Coronary Graft in a Patient with Pectus Excavatum
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概要
- 論文の詳細を見る
A 26-year-old man presented chest oppression. He had pectus excavatum associated with Loeys-Dietz syndrome and a history of redo aortic root replacement with the modified Bentall technique using an 8-mm long interposed graft to the left coronary ostium. Coronary angiography revealed severe stenosis of both left coronary ostium and proximal left anterior descending artery, which was supposed to be resulted from thrombosis in the interposed graft. The left coronary system was bypassed through a left thoracotomy, which was suitable in this patient because the pectus excavatum would prevent harvest of the left internal thoracic artery through re-median sternotomy and to avoid potential sternal reentry injury of the heart. Although the left anterior descending artery was easily accessed under off-pump technique, exposure and anastomosis of the circumflex coronary artery was more difficult than expected without cardiopulmonary bypass as the pectus excavatum and adhesion of the heart prevented anterior shift and rotation of the heart.
著者
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Motoki Manabu
Department Of Cardiovascular Surgery Osaka City University Graduate School Of Medicine
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Takahashi Yosuke
Department Of Cardiovascular Surgery Fukui Cardiovascular Center
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Shibata Toshihiko
Department Of Cardiothoracic Vascular Surgery Osaka City General Hospital
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Nishimura Shinsuke
Department Of Internal Medicine Kyorinkai Murakami Memorial Hospital
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Hattori Koji
Department Of Applied Biological Sciences Saga University
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Kato Yasuyuki
Department of Biomolecular Engineering, Tokyo Institute of Technology, 4259 Nagatsuta, Midori-ku, Yokohama 226-8501, Japan
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Hattori Koji
Department of Cardiovascular Surgery, Osaka City General Hospital, Miyakojima-ku, Osaka, Japan
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Shibata Toshihiko
Department of Cardiovascular Surgery, Osaka City General Hospital, Miyakojima-ku, Osaka, Japan
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Nishimura Shinsuke
Department of Cardiovascular Surgery, Osaka City General Hospital, Miyakojima-ku, Osaka, Japan
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Motoki Manabu
Department of Cardiovascular Surgery, Osaka City General Hospital, Miyakojima-ku, Osaka, Japan
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