骨髓移植患者冠状动脉搭桥术中可以使用左乳内动脉吗?首例病例报告

IF 0.4 Q4 ONCOLOGY International Journal of Cancer Management Pub Date : 2023-04-04 DOI:10.5812/ijcm-121669
Mahmoud Beheshti Monfared, H. Ghaderi, Zahra Ansari Aval, M. Hekmat, S. Mirjafari, Reza Beheshtimonfared
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引用次数: 0

摘要

导言:随着肿瘤治疗的进步和肿瘤患者生存率的提高,我们进入了一个必须处理老年患者并发症的新时代。骨融合的问题或其延迟的副作用,如畸形愈合或感染,是任何手术中对骨髓受治疗影响或骨髓血流受损的患者的关注之一。左乳内动脉(LIMA)用于冠状动脉旁路移植术(CABG),其寿命比隐静脉移植长2 - 3倍,但从胸骨提取LIMA会影响胸骨血流,并且在接受骨髓移植的患者中使用LIMA的结果仍未确定。本病例报告是关于这一问题的第一份报告。病例介绍:60岁男性弥漫性大B细胞淋巴瘤患者,一年前接受骨髓移植后出现胸痛,诊断为血管疾病;他被选为CABG手术。术中切除左前降支,吻合左前降支。隐静脉移植物还与斜动脉、钝缘动脉(OM)、后降支(PDA)和左后心室(PLV)吻合。术后随访6个月,无特殊事件发生,无胸骨相关并发症。结论:在本病例报告中,在接受骨髓移植和冠脉搭桥手术的患者中使用LIMA与胸骨相关并发症的增加无关。
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Can the Left Internal Mammary Artery Be Used During Coronary Artery Bypass Graft Surgery in Patients Undergoing Bone Marrow Transplant? A First Case Report
Introduction: With the improvements in neoplasm treatments and the increased survival of patients with neoplastic diseases, we have entered a new era of having to deal with the complications of senile patients. The issue of bone fusion or the side effects of its delay, such as malunion or infections, are among the concerns for any surgery in patients whose bone marrow is affected by treatment or whose bone marrow blood flow is impaired. The left internal mammary artery (LIMA) is used for coronary artery bypass graft (CABG) surgery with its 2 - 3 times longer lifespan compared to saphenous vein grafts, but its harvest from the sternum affects the sternum blood flow and the outcome of its use is still not identified in patients undergoing bone marrow transplant. This case report is the first report on this issue. Case Presentation: A 60-year-old man with diffuse large B cell lymphoma who had undergone bone marrow transplant a year before had then developed chest pain, which was diagnosed as vessel disease; he was selected for CABG surgery. The LIMA was harvested during the surgery and the left anterior descending artery (LAD) was anastomosed. The saphenous vein graft was also anastomosed to the diagonal artery, obtuse marginatus (OM), posterior descending artery (PDA), and posterior left ventricle (PLV). After the surgery, the patient was followed up for six months, during which time no specific incidents occurred and no sternum-related complications were observed either. Conclusions: In this case report, the use of LIMA in a patient who had undergone a bone marrow transplant and CABG surgery was not associated with any increase in sternum-related complications.
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CiteScore
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发文量
67
期刊介绍: International Journal of Cancer Management (IJCM) publishes peer-reviewed original studies and reviews on cancer etiology, epidemiology and risk factors, novel approach to cancer management including prevention, diagnosis, surgery, radiotherapy, medical oncology, and issues regarding cancer survivorship and palliative care. The scope spans the spectrum of cancer research from the laboratory to the clinic, with special emphasis on translational cancer research that bridge the laboratory and clinic. We also consider original case reports that expand clinical cancer knowledge and convey important best practice messages.
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