PDF(Pubmed)
Abstract：
A 64-year-old woman had undergone coronary artery bypass grafting (CABG) for right coronary occlusion and the Dor procedure for a left ventricular apex aneurysm 10 years previously. A follow-up computed tomography scan showed the evolution of a giant coronary artery aneurysm (CAA) located on the proximal left circumflex artery (CX). It also revealed a previous saphenous vein graft (SVG) that was patent and located on the midline. Surgical exclusion was regarded as invasive, and isolated percutaneous intervention was unsuitable for a wide-necked CAA. Thus, a hybrid approach was planned. First, CABG (SVG-CX) via left thoracotomy was performed. Following the surgery, stent-assisted coil embolization was performed. A coronary angiogram revealed complete CAA exclusion.
UNASSIGNED: Many authors have reported successful repair for coronary artery aneurysm (CAA) with a percutaneous approach or surgery. Although there is no consensus for giant CAA repair, surgical repair including resection, ligation, and coronary artery bypass grafting have been recommended in previous reports. However, every decision should be tailored to suit each condition. In this case with the history of previous cardiovascular surgery, our hybrid approach was thought to be less invasive and feasible than isolated surgical or percutaneous repair.
UNASSIGNED: Many authors have reported successful repair for coronary artery aneurysm (CAA) with a percutaneous approach or surgery. Although there is no consensus for giant CAA repair, surgical repair including resection, ligation, and coronary artery bypass grafting have been recommended in previous reports. However, every decision should be tailored to suit each condition. In this case with the history of previous cardiovascular surgery, our hybrid approach was thought to be less invasive and feasible than isolated surgical or percutaneous repair.
摘要：
一名64岁的妇女在10年前接受了右冠状动脉闭塞的冠状动脉旁路移植术（CABG）和左心室心尖动脉瘤的Dor手术。随访计算机断层扫描扫描显示位于左旋支动脉（CX）近端的巨大冠状动脉瘤（CAA）的演变。它还显示了先前的隐静脉移植物（SVG），该移植物是专利的，位于中线。手术排斥被认为是侵入性的，孤立的经皮介入不适合宽颈CAA。因此，计划采用混合方法。首先,通过左开胸进行CABG（SVG-CX）。手术后,进行支架辅助线圈栓塞。冠状动脉造影显示完全排除CAA。
■许多作者报道了经皮穿刺或手术成功修复冠状动脉瘤（CAA）。虽然对于巨型CAA修复没有共识，手术修复包括切除，结扎,和冠状动脉旁路移植术在以前的报告中已被推荐。然而,每个决定都应该适合每个条件。在这种情况下，有以前的心血管手术史，与单独的手术或经皮修复相比,我们的混合方法被认为具有较小的侵入性和可行性.
■许多作者报道了经皮穿刺或手术成功修复冠状动脉瘤（CAA）。虽然对于巨型CAA修复没有共识，手术修复包括切除，结扎,和冠状动脉旁路移植术在以前的报告中已被推荐。然而,每个决定都应该适合每个条件。在这种情况下，有以前的心血管手术史，与单独的手术或经皮修复相比,我们的混合方法被认为具有较小的侵入性和可行性.
