Rescue of Coronary Injury with Right Internal Mammary Artery Bypass during Repair of a Complex Congenital Heart

在复杂先天性心脏病修复术中,采用右侧乳内动脉搭桥术挽救冠状动脉损伤

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Abstract

A 10-year-old boy with polysplenia syndrome was diagnosed with complex congenital heart disease, including common atrium, bilateral superior vena cava, complete atrioventricular canal defect, severe pulmonary stenosis, interrupted inferior vena cava, and patent ductus arteriosus. Previously, he underwent a bilateral bidirectional Glenn shunt operation with ligation of the patent ductus arteriosus in April, 2009, when he was six years old. During the operation, his left anterior descending coronary artery (LAD) was injured accidently due to abnormally high coronary artery takeoff. Consequently, a coronary artery bypass graft [right internal mammary artery (RIMA) to LAD proximal, end-to-end] was performed. On July 24, 2013, he received the last stage of a total cavopulmonary connection with an extracardiac conduit (22 mm PTFE graft) at ten years of age. The RIMA was not injured during redo-sternotomy and he was discharged uneventfully 11 days after the operation. KEY WORDS: Congenital heart disease; Coronary artery bypass surgery; Coronary injury.

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