Empty-beating Technique Reduces the Ischemic Time in a Combined Ascending Aortic Grafting and Coronary Artery Bypass Procedure - A Case Report

無負荷空跳技術減少上升主動脈置換合併冠狀動脈繞道術之心肌缺氧時間－病例報告

諶大中(Ta-Chung Shen) ； 林庭光(Tin-Kwang Lin) ； 林老生(Rou-Sei Rim)

《慈濟醫學雜誌》 16卷4期 (2004/08) Pp. 257-260

https://doi.org/10.6440/TZUCMJ.200408.0257

摘要

診斷性心導管時併發腹部主動脈剝離並延伸至上升主動脈至今並無文獻報告。雖然必須緊急開刀，但當有嚴重冠狀動脈狹窄及左心室功能異常時，手術之風險相對上升。我們在此報告一個心肌梗塞後不穩定心絞痛並有鬱血性心衰竭的病人，在接受診斷性心導管時併發上述合併症。我們成功地用無負荷空跳及深低溫停循環技術完成上升主動脈置換合併冠狀動脈繞道手術。

關鍵字

心絞痛 ； 主動脈剝離 ； 不停跳 ； 停循環 ； 冠狀動脈繞道手術

並列摘要

Abdominal aortic dissection with retrograde extension to the ascending aorta during diagnostic coronary catheterization has not been reported before. Although, immediate surgery is indicated, the surgical risks are high when there are severe coronary lesions and impaired ventricular function. We describe a patient with post-myocardial infarction unstable angina and congestive heart failure who had this type of aortic dissection during catheterization. Emergent coronary artery bypass grafting with an empty-beating heart and ascending aortic grafting under deep hypothermic circulatory arrest were successfully done. The patient recovered well and is currently followed up in our out-patient department.

並列關鍵字

angina ； aortic dissection ； beating heart ； circulatory arrest ； coronary artery bypass surgery