RESUMEN
A 61-year-old man with diabetes mellitus and chronic bronchitis was brought to the hospital after falling from a roof accidentally. He received blunt trauma to the left chest wall including left rib fractures, pneumothorax, hemothorax and a fracture of left scapula. After endotracheal intubation and chest drainage, he was transferred to the intensive care unit. Sixteen days later, congestive heart failure appeared. Echocardiography showed a severe aortic valve regurgitation with a prolapse of non-coronary cusp. Eight months after the injury, his heart failure deteriorated. He underwent aortic valve replacement with a mechanical prosthesis. Upon examining the aortic valve, we noted 2 perforations in the non-coronary cusp of the aortic valve. Postoperative course was uneventful.
Asunto(s)
Insuficiencia de la Válvula Aórtica/cirugía , Bronquitis/complicaciones , Implantación de Prótesis de Válvulas Cardíacas , Traumatismos Torácicos/etiología , Heridas no Penetrantes/etiología , Accidentes Domésticos , Válvula Aórtica/cirugía , Insuficiencia de la Válvula Aórtica/etiología , Enfermedad Crónica , Humanos , Masculino , Persona de Mediana Edad , Fracturas de las Costillas/etiología , Fracturas del Hombro/etiologíaRESUMEN
As total arterial revascularization in coronary artery bypass grafting (CABG) has been recommended, a sequential bypass technique using arterial grafts has been induced. We evaluate whether a sequential bypass graft can be functioned or not by using a simple simulation model for coronary circulation analogous to the electrical circuit based on Ohm law. The ratio of flow between graft and native coronary artery was determined by the severity of stenosis in the bypassed vessels and the graft diameter. In selection for sequential bypass technique, these factors should be taken into consideration.