모야모야 환자에게서의 인공심폐기를 이용한 개심술
-1예 보고-
Cardiac Surgery Using CPB in Moyamoya Disease
-A Case Report-
Moyamoya disease is an unusual cerebrovascular disorder characterized by occlusive intimal dysplasia of the distal internal carotid and proximal cerebral arteries, but the etiology remains unclear. Angiographic characteristics include bilateral stenosis or occlusion of the terminal portions of the intracranial internal carotid arteries and bilateral development of fine collateral vessels at the base of the brain known as ‘Moyamoya vessels’. Cardiac surgery using cardiopulmonary bypass due to coronary artery disease and others among patients with moyamoya disease is very rare, and cardiac surgery for such patients has a potential risk of intraoperative and perioperative brain ischemia. We successfully treated a patient who underwent artrial septal defect closure and coronary artery bypass graft using the cardiopulmonary bypass, so we report this case with a brief literature review.
(Korean J Thorac Cardiovasc Surg 2003;36:772-775) Key words
:1. Cerebral circulation
2. Heart septal defect, atrial
3. Coronary artery bypass
Fig. 1. Preoperative chest PA, showing cardiomegaly, increas- ed pulmonary conus and vascularity.
Fig. 4. Postoperative Brain CT
& Chest PA.
Fig. 3. A: Preoperative cerebral angiography, showing bilateral supraclinoid obstruction, no bila- teral ACA and MCA flow and numerous fine collaterals (Moya- moya vessels). B: Preoperative cerebral angiography, showing PCA stenosis with leptomen- ingeal collateral vessels.
Fig. 2. A: Preoperative Brain CT. B: Preoperative Brain MRI, showing old CVA lesion at right occipital area, ICH of left tha- lamic area and left IVH.
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