| A Case of Marfan's Syndrome Following
Cabrol's Operation That Underwent Off-Pump Beating Coronary Artery
Bypass Grafting for Stenosis of Anastomosis between the Left
Main Coronary Artery Ostium and Small Vascular Prosthesis |
(Department of Thoracic and Cardiovascular Surgery,
Osaka Medical College, Takatsuki, Japan)
| Kotaro Tsunemi |
Yoshihide Sawada |
Fuyo Tsukiyama |
| Keiichiro Kondo |
Shinjiro Sasaki |
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We report a case of Marfan's syndrome
in a patient who, 20 months after undergoing Cabrol's operation,
underwent beating coronary artery bypass grafting without the
aid of cardiopulmonary bypass for ostial stenosis of the left
main coronary artery after acute myocardial infarction was diagnosed.
The patient was a 31-year-old woman who had undergone Cabrol's
operation for annulo-aortic ectasia at 29 years of age, and whose
course thereafter was uneventful. On May 26,2000, she complained
of chest pain, and was admitted to our hospital with a diagnosis
of acute myocardial infarction. On June 17 of the same year,
a 90% ostial stenosis of the left main coronary artery was detected
by coronary angiography. She subsequently underwent beating coronary
artery bypass grafting without the aid of cardiopulmonary bypass,
using left internal thoracic artery (LITA) anastomosis to the
left anterior descending artery (LAD) via median sternotomy.
The LAD was so much displaced laterally and pericardial adhesion
was so dense on the apical aspect that good visualization of
the LAD could not be obtained by the conventional percardiotomy.
Therefore, the pericardium over the contemplated LAD anastomosis
was resected circularly, and the LITA was anastomosed to the
LAD through the pericardial opening. Postoperative angiography
showed a widely patent LITA, although the stenotic lesion of
the left main coronary ostium was totally occluded.
Jpn. J. Cardiovasc. Surg. 32：41-44（2003） |
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