经皮冠状动脉介入术治疗外科二尖瓣和主动脉瓣瓣膜置换术后左主干完全闭塞1例

高好考; 贾慧丰; 李成祥

doi:10.13201/j.issn.1001-1439.2023.11.016

经皮冠状动脉介入术治疗外科二尖瓣和主动脉瓣瓣膜置换术后左主干完全闭塞1例

- 1.
  空军军医大学西京医院心脏内科(西安，710032)
- 2.
  陕西省大荔县县医院介入科

详细信息

通讯作者: 李成祥，E-mail：lichx1@163.com

中图分类号: R654.3

收稿日期: 2023-02-21

刊出日期: 2023-11-13

Percutaneous coronary intervention in the treatment of chronic total occlusion of the left main trunk after mitral and aortic valve surgicalreplacement: a case report

- 1.
  Department of Cardiology, Xijing Hospital, Air Force Medical University, Xi'an, 710032, China
- 2.
  Department of Intervention, Dali County Hospital

More Information

Corresponding author: LI Chengxiang, E-mail: lichx1@163.com

Received Date: 21 February 2023

Publish Date: 13 November 2023

摘要

摘要: 外科主动脉瓣置换术后的冠状动脉(冠脉)狭窄是一种罕见但危及生命的并发症，临床症状通常很严重，大多出现在术后1~6个月。本文报道1例外科主动脉和二尖瓣置换术3年后发现冠脉左主干慢性完全闭塞病例，患者接受经皮冠脉介入术植入药物洗脱支架成功治疗。
- 外科主动脉瓣置换术 /
- 慢性完全闭塞 /
- 经皮冠状动脉介入术
Abstract: Coronary artery stenosis after surgical aortic valve replacement (AVR) is a rare but life-threatening complication, and clinical symptoms are usually severe, mostly appearing about 1-6 months after surgery. We reported a case of chronic total occlusion of the left main coronary artery after surgical aortic and mitral valve replacement up to 3 years, which was successfully treated by percutaneous coronary intervention implantation of drug-eluting stents. As far as we knew, this was the most serious lesion and management of the left main coronary artery after surgical AVR was reported in China.
- aortic valve replacement /
- chronic total occlusion /
- percutaneous coronary intervention

HTML全文

图 1 冠脉造影结果

Figure 1. Coronary angiography results

下载: 全尺寸图片幻灯片

图 2 左冠脉血管开通过程

Figure 2. The opening process of left coronary artery

下载: 全尺寸图片幻灯片

参考文献(11)

[1]	董念国, 曹红, 周廷文, 等. 心脏瓣膜病治疗进展[J]. 临床心血管病杂志, 2022, 38(6): 429-436. https://lcxxg.whuhzzs.com/article/doi/10.13201/j.issn.1001-1439.2022.06.001
[2]	Roberts WC, Morrow AG. Late postoperative pathological findings after cardiac valve replacement[J]. Circulation, 1967, 35(4 Suppl): I48-62.
[3]	Yates JD, Kirsh MM, Sodeman TM, et al. Coronary ostial stenosis, a complication of aortic valve replacement[J]. Circulation, 1974, 49(3): 530-534. doi: 10.1161/01.CIR.49.3.530
[4]	Trimble AS, Bigelow WG, Wigle ED, et al. Coronary ostial stenosis[J]. J Thorac Cardiovasc Surg, 1969, 57: 792. doi: 10.1016/S0022-5223(19)42653-6
[5]	Nakhjavan FK, Maranhao V, Goldberg H. Iatrogenic stenosis of the proximal portion of the coronary arteries. Report of three cases treated with aortocoronary anastomosis[J]. Am Heart J, 1972, 83(3): 318-321. doi: 10.1016/0002-8703(72)90431-0
[6]	Alsaddah J, Alkandari S, Younan H. Iatrogenic left main coronary artery stenosis following aortic and mitral valve replacement[J]. Heart Views, 2015, 16(1): 37-39. doi: 10.4103/1995-705X.153001
[7]	Yates JD, Kirsh MM, Sodeman TM, et al. Coronary ostial stenosis, a complication of aortic valve replacement[J]. Circulation, 1974, 49(3): 530-534. doi: 10.1161/01.CIR.49.3.530
[8]	Chavanon O, Carrier M, Cartier R, et al. Early reoperation for iatrogenic left main stenosis after aortic valve replacement: a perilous situation[J]. Cardiovasc Surg, 2002, 10(3): 256-263. doi: 10.1177/096721090201000313
[9]	Raja Y, Routledge HC, Doshi S. Coronary stenting for iatrogenic stenosis of the left main coronary artery post-aortic valve replacement: an alternative treatment?[J]. Eur J Cardiothorac Surg, 2011, 39(3): 398-400. doi: 10.1016/j.ejcts.2010.07.001
[10]	Balbi M, Olivotti L, Scarano F, et al. Percutaneous treatment of left main coronary stenosis as a late complication of bentall operation for acute aortic dissection[J]. Catheter Cardiovasc Interv, 2004, 62(3): 343-345. doi: 10.1002/ccd.20115
[11]	畅晓燕, 赵江峰. 经皮冠状动脉介入治疗慢性完全闭塞病变对患者心脏功能的影响[J]. 临床心血管病杂志, 2021, 37(3): 220-223. https://lcxxg.whuhzzs.com/article/doi/10.13201/j.issn.1001-1439.2021.03.007