内胸動脈グラフト採取による下肢虚血の検出に下肢組織酸素飽和度が有用であった症例

An Adult Anomalous Origin of the LCA from the PA Complicated by Left Common Iliac Artery Occlusion：A Favorable Outcome with Intraoperative Regional Oxygen Saturation and Lower Extremity Blood Flow Evaluations

要旨

　左総腸骨動脈閉塞を合併した成人左冠動脈肺動脈起始症患者に左冠動脈肺動脈開口部閉鎖術および冠動脈バイパス手術（左内胸動脈-前下行枝）を施行した。左内胸動脈が下肢への側副血行路となっており，術中に組織酸素飽和度を測定して下肢血流を評価，治療介入を行うことで下肢虚血に伴う合併症を認めず，良好な経過を得た。

　A 50-year-old man with an anomalous origin of the left coronary artery（LCA）from the pulmonary artery（PA）complicated with left common iliac artery occlusion underwent closure of the PA orifice of the LCA and coronary artery bypass surgery（left internal thoracic artery-left anterior descending［LITA-LAD］）. Because the LITA was a collateral blood route to the lower extremity due to the occlusion of the left common iliac artery, the intraoperative evaluation of blood flow to the lower extremity by regional oxygen saturation revealed that the patient had a good outcome without complications due to ischemia of the lower extremity.