초록접수 현황
| 16F-057 | 포스터 발표 |
Coronary Occlusion after the Manouguian Procedure in a Patient with a Single Coronary Artery: A Case Report
Yochun Jung¹, Gwan Sic Kim¹, Kyo Seon Lee¹, In Seok Jeong¹, Sang Gi Oh¹, Kook Joo Na², Kye Hun Kim³, Byoung Hee Ahn¹
¹Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital, Chonnam National University College of Medicine, Gwangju, Korea, ²Chonnam National University Hwasun Hospital, Chonnam National University College of Medicine, Jeollanam-do, Korea, ³Department of Cardiovascular Medicine, Chonnam National University Hospital, Chonnam National University College of Medicine, Gwangju, Korea
Background : The association between the anatomy of a single coronary artery (SCA) and the surgical risk of aortic valve replacement (AVR) remains unclear due to a lack of studies on this topic.
Methods : A 73-year-old woman underwent AVR for aortic stenosis. Preoperative coronary angiography results showed a SCA arising from the left coronary sinus. The Manouguian procedure was performed for a small aortic annulus. Intraoperatively, an extracorporeal membrane oxygenator (ECMO) was needed for bypass weaning failure due to newly developed right ventricular dysfunction.
Results : Coronary angiography was performed on postoperative day 4, and the findings showed a right coronary artery occlusion just after its origin. After emergent coronary artery bypass surgery, she could be weaned from the ECMO. She was discharged on postoperative day 70 and followed up without complications for 12 months.
Conclusion : AVR with the annular enlargement procedure in those with a SCA can result in an unexpected coronary artery occlusion, which should be, therefore, suspected when unexplained myocardial dysfunction occur. For reducing this risk, the use of a small prosthesis should be considered over the annular enlargement procedure when performing AVR in those with a small aortic annulus and a SCA.
Methods : A 73-year-old woman underwent AVR for aortic stenosis. Preoperative coronary angiography results showed a SCA arising from the left coronary sinus. The Manouguian procedure was performed for a small aortic annulus. Intraoperatively, an extracorporeal membrane oxygenator (ECMO) was needed for bypass weaning failure due to newly developed right ventricular dysfunction.
Results : Coronary angiography was performed on postoperative day 4, and the findings showed a right coronary artery occlusion just after its origin. After emergent coronary artery bypass surgery, she could be weaned from the ECMO. She was discharged on postoperative day 70 and followed up without complications for 12 months.
Conclusion : AVR with the annular enlargement procedure in those with a SCA can result in an unexpected coronary artery occlusion, which should be, therefore, suspected when unexplained myocardial dysfunction occur. For reducing this risk, the use of a small prosthesis should be considered over the annular enlargement procedure when performing AVR in those with a small aortic annulus and a SCA.
책임저자: Byoung Hee Ahn
Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital, Chonnam National University College of Medicine, Gwangju, Korea
발표자: Yochun Jung, E-mail : yochuni@naver.com