瓣膜替换术中冠状动脉急性阻塞的诊断及处理

Diagnosls and management On acute coronary arteryocclusion in valve replacement surgery:a report offour cases

作者报告４例瓣膜替换术中冠状动脉急性阻塞的处理经验。例１为典型马凡综合征行Ｃａｂｒｏｌ手术；例２为先天性两叶瓣伴单支右冠状动脉畸形行ＡＶＲ；例３和例４均为风心联合瓣膜病行ＤＶＲ和三尖瓣环缩术。术毕均出现左冠状动脉急性阻塞表现，心脏复苏困难，紧急作大隐静脉前降支搭桥术后，均脱离辅助循环。术后存活２例。作者分析了冠状动脉急性阻塞的原因、诊断进行了讨论和处理。

Abstract This paper reported four cases of acute coronaryartery occlusion occurred during valve replacementprocedure,Case 1 was of Marfan′s svndrome who un-derwent Cabrol procedure。 Case 2 was of congenitalaortic bileaflet malformation with severe regurgitationand simple right coronary artery,who received theprocedure of AVR,Both case 3 and 4 suffered fromrheumatic valve disease who were given DVR andtricuspid valve annuloplasty。 All the cases had acuteleft coronarv arterv occlusion and did not revive afterremoval of aortic cross-damp,whichwere immedi-ately corrected by coronary bapass grafts from aortic toleft descending branch with saphonous veins,All thepatients successfully weaned from asistant circulation。Two cases survived.The causes of acute coronarvartery occlusion were analyzed and the diagnosticmethods and management introduced.