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A Case of Stenosis of the Main Trunk of the Left Coronary Artery Caused by Dissecting of an Aolrtic Aneurysm Tomohiro Nishinaka 1 , Hiroyuki Tokunaga 1 , Keiichi Kebukawa 2 , Sanae Takahashi 2 , Masahiro Endo 3 , Hiroshi Nishida 3 , Shigeyuki Aomi 3 , Hitoshi Koyanagi 3 1Department of Cardiovascular Surgery, Kousei General Hospital 2Department of Cardiology, Kousei General Hospital 3Department of Cardiovascular Surgery, The Heart Institute of Japan, Tokyo Women's Medical College Keyword: 解離性大動脈瘤 , パーフュージョンカテーテル , dissection of aorta , perfusion catheter pp.391-394
Published Date 1997/4/15
DOI https://doi.org/10.11477/mf.1404900032
  • Abstract
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A 61-year-old woman was admitted to our hospital complaining of chest pain. Twelve hours later, she developed cardiogenic shock. and circulation assistance with intra-aortic balloon pumping was commenced. Coronary angiography showed severe stenosis of the main trunk of the left coronary artery. Percutaneous transluminal coronary angioplasty (PTCA) was attemped, but failed. A perfusion catheter was inserted in the left main trunk. Later it was revealed that the cause of cardiogenic shock was severe coronary stenosis caused by compression by a dissecting aortic aneurysm (Dehakey type I). Seven days later, she had recovered from multiple organ failure, and underwent an opera-tion for replacement of the ascending aorta with an artificial graft, and coronary artery bypass grafting (CABG) to the anterior descending branch of the left coronary artery. In cases of acute occlusion after PTCA, a perfusion catheter is often used for a short time until emergency CABG is carried out. When a patient ievelops cardiogenic shock and surgery cannot he safely performed, to save life, a perfusion catheter allows surgery to be delayed until recovery of the general condition of the patient is attained.


Copyright © 1997, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1200 印刷版ISSN 0452-3458 医学書院

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