Iyisoy Atila, Kursaklioglu Hurkan, Kose Sedat, Yesilova Zeki, Ozturk Cengiz, Saglam Kenan, Demirtas Ertan
Gulhane Military Medical Academy, Department of Cardiology, 06018 Etlik, Ankara, Turkey.
Mt Sinai J Med. 2004 Oct;71(5):330-4.
A 42-year-old woman with Behcet's disease and pericardial effusion for 14 years presented with acute myocardial infarction and received thrombolytic therapy. Coronary angiography showed total occlusion of the left anterior descending artery. Subsequently, the left internal mammary artery was grafted to the left anterior descending artery. Approximately one year after bypass surgery, digital subtraction angiography of the left subclavian artery, performed because of chest and left arm pain, showed total occlusion of the left subclavian artery. Retrograde flow from the left vertebral artery filled the distal portion of the left subclavian artery. In conclusion, patients with Behcet's disease should be investigated closely for involvement of other arteries when one vessel's involvement has been detected. We also recommend that free arterial grafts be used for any coronary surgical intervention, because of the risk of occlusion associated with the vasculitis of Behcet's disease.
一名患有白塞病且心包积液14年的42岁女性,出现急性心肌梗死并接受了溶栓治疗。冠状动脉造影显示左前降支完全闭塞。随后,将左乳内动脉移植到左前降支。搭桥手术后约一年,因胸部和左臂疼痛进行的左锁骨下动脉数字减影血管造影显示左锁骨下动脉完全闭塞。来自左椎动脉的逆行血流充盈了左锁骨下动脉的远端部分。总之,当检测到白塞病患者的某一支血管受累时,应密切检查其他动脉是否受累。由于白塞病血管炎相关的闭塞风险,我们还建议在任何冠状动脉手术干预中使用游离动脉移植物。