Résumé
Abstract Buerger's disease, vasculitis of small and medium-sized blood vessels, is a non-atherosclerotic and progressive occlusive condition which frequently involves the distal part of the limbs. The occlusion of coronary arteries in Buerger's disease is a rare condition; however, coronary artery dissection has not been reported previously. Therefore, this paper presents a 45-year-old man who developed coronary artery dissection associated with Buerger's disease. The patient was treated successfully with coronary artery bypass grafting with the left internal mammary artery to the left anterior descending artery, and saphenous vein graft to the right coronary artery.
Sujets)
Humains , Mâle , Adulte d'âge moyen , Thromboangéite oblitérante/complications , Maladie des artères coronaires/étiologie , Occlusion coronarienne/étiologie , Veine saphène/transplantation , Thromboangéite oblitérante/chirurgie , Maladie des artères coronaires/chirurgie , Maladie des artères coronaires/imagerie diagnostique , Pontage aortocoronarien/méthodes , Coronarographie/méthodes , Occlusion coronarienne/chirurgie , Occlusion coronarienne/imagerie diagnostique , Angiographie par tomodensitométrie/méthodes , Artères mammaires/chirurgieRésumé
AbstractObjective:This study aimed to show the effects of intra-operative diltiazem infusion on flow in arterial and venous grafts in coronary artery bypass graft surgery.Methods:Hundred fourty patients with a total of 361 grafts [205 (57%) arterial and 156 (43%) venous] underwent isolated coronary surgery. All the grafts were measured by intraoperative transit time flow meter intra-operatively. Group A (n=70) consisted of patients who received diltiazem infusion (dose of 2.5 microgram/kg/min), and Group B (n=70) didn't receive diltiazem infusion.Results:Mean graft flow values of left internal mammary artery were 53 ml/min in Group A and 40 ml/min in Group B (P<0.001). Pulsatility index (PI) values of left internal mammary artery for Group A and Group B were 2.6 and 3.0 respectively (P<0.001). No statistically significant difference was found between venous graft parameters.Conclusion:We recommend an effect of diltiazem infusion in increasing graft flows in coronary artery bypass graft operations.
ResumoObjetivo:Este estudo teve como objetivo mostrar os efeitos da infusão de diltiazem intraoperatória no fluxo arterial e enxertos venosos em cirurgia de revascularização do miocárdio.Métodos:Cento e quarenta pacientes com um total de 361 enxertos [205 (57%) arteriais e 156 (43%) venosos] passaram por uma cirurgia coronária isolada. Todos os enxertos foram medidos pelo medidor de fluxo de tempo de trânsito intraoperatório. Grupo A (n=70), formado por pacientes que receberam infusão de diltiazem (dose de 2,5 micrograma/kg/min), e Grupo B (n=70), por aqueles que não receberam infusão de diltiazem.Resultados:Os valores médios de fluxo de enxerto de artéria mamária interna esquerda foram 53 ml/min no grupo A e 40 ml/min no Grupo B (P<0,001). Valores do índice de pulsatilidade da artéria mamária interna esquerda para o Grupo A e do Grupo B foram de 2,6 e 3,0, respectivamente (P<0,001). Não houve diferença estatisticamente significativa entre os parâmetros do enxerto venoso.Conclusão:Sugerimos um efeito da infusão de diltiazem em aumentar os fluxos de enxerto em operações de bypass de artéria coronária.