[A case of coronary artery bypass grafting after unsuccessful PTCA in a patient with systemic lupus erythematosis].
For angina of effort in a 69-year-old male patient who had been on steroid for SLE for 7 years we performed PTCA. However, with no dilation obtained we were compelled to perform CABG. The left internal thoracic artery was anastomosed with seg. 12 and the left great saphenous vein was anastomosed sequentially with seg. 14 and seg. 4PL. Through coronary angiography performed at postoperative 2 months, the vein graft was found well patent but in the left internal thoracic artery 90%-stenosis was observed at the anastomosed part, for which PTCA was performed to have it dilated up to 25%. In patho-histological examinations, intimal hypertrophy was observed in both grafts, which seemed to suggest a possible risk factor to determine long-term prognosis. In cases of SLE, the frequency of occurrences of ischemic heart diseases is high, indicating probabilities to be taken up as serious complication from now on. Until now, however, there are few instances reported on performing CABG for patients with SLE. We are reporting here our studies of this particular case of SLE, discussing the involvement of steroids, angitis and lupus anticoagulants as causative factors of ischemic heart diseases and related issues of surgical treatments.
Terai
H
H
Department of Cardiovascular Surgery, Kumamoto-Chuuou Hospital, Japan.
Sakata
R
R
Higuchi
K
K
Funazu
H
H
D000368:Aged; D000787:Angina Pectoris / Q000209:etiology / Q000601:surgery*; D015906:Angioplasty, Balloon, Coronary; D001026:Coronary Artery Bypass; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications*; D008297:Male