Dev bir sol internal mammaryen ile koroner arter bypass greftleme; Eş zamanlı aort koarktasyonu ve koroner arter hastalığı olan hastada dilate internal mammaryen arter kullanımı

Eş zamanlı aort koarktasyonu ile koroner arter hastalığı gibi diğer kardiyak patolojileri olan hastalarda ideal tedavi yaklaşımı konusunda fikir birliği bulunmamaktadır. 69 yaşında erkek hasta hastanemize karotid arter darlığı ve koroner arter hastalığı tanılarıyla başvurdu. Ameliyat öncesi hazırlıklar sırasında hastada aynı zamanda aort koarktasyonu olduğu saptandı. Sol internal mammaryen arter dilateydi ancak yine de koroner arter bypass greftleme operasyonu sırasında greft olarak kullanıldı. Biz bu hastadaki yaklaşımımızı sunmak istedik.

Anahtar Kelimeler:

aort koarktasyonu, internal mammaryen arter, koroner arter hastalığı

Performing coronary artery bypass grafting with a giant left internal mammary artery; Using dilated internal mammary artery in a patient with aortic coarctation and concomitant coronary artery disease

The ideal surgical approach is unclear for patients with aortic coarctation whom have other associated coronary artery disease or other cardiac pathologies. A 69 year-old male was admitted to our hospital with carotid artery stenosis and coronary artery disease. During routine preoperative procedures cardiologist revealed an aortic coarctation. Left internal mammary artery was dilated due to coarctation but even so it was used as a graft for coronary artery bypass grafting. We aimed to report our approach for this patient.

Keywords:

aortic coarctation, internal mammary artery, coronary artery disease,

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Laks H, Marelli D, Plunkett M, Odim J, Myers J. Adult congenital heart disease. In Cardiac Surgery in the adult. 2nd edition. Edited by Lawrence H Cohn and L. Henry Edmunds Jr. New York, McGraw - Hill; 2003: 1329-58.
Atipo-Galloye R, Rhissassi J, Koulekey C. Dilatation of internal mammary arteries in adult presenting aortic coarctation. Asian Cardiovasc Thorac Ann 2014; 22: 365.
Alvarez JR, Lopez LR, Quiroga JS, Martinez Comendador JM, Martinez-de-Alegria A, Martinez Cereijo JM, Dominguez CD. Internal mammary artery dilatation in a patient with aortic coarctation, aortic stenosis, and coronary disease. Case report. J Cardiothorac Surg 2011; 6: 55.
Yilmaz M, Polat B, Saba D. Single-stage repair of adult aortic coarctation and concomitant cardiovascular pathologies: a new alternative surgical approach. J Cardiothorac Surg 2006; 1: 18.
Goldman S, Zadina K, Moritz T, Ovitt T, Sethi G, Copeland JG, Thottapurathu L, Krasnicka B, Ellis N, Anderson RJ, Henderson W. Long-term patency of saphenous vein and left internal mammary artery grafts after coronary artery bypass surgery: results from a Department of Veterans Affairs Cooperative Study. J Am Coll Cardiol 2004; 44: 2149-56.
Mario Gaudino, Piero Farina, Amelia Toesca, Giorgia Bonalumi, Vasileios Tsiopoulos, Piergiorgio Bruno and Massimo Massetti: The use of internal thoracic artery grafts in patients with aortic coarctation. Eur J Cardiothorac Surg 2013; 44: 415-18.