左主干冠状动脉夹层支架置入术及急性A型主动脉夹层覆膜支架植入术。
Stenting of a left main coronary artery dissection and stent-graft implantation for acute type a aortic dissection.
作者信息
Imoto Kiyotaka, Uchida Keiji, Suzuki Shinichi, Isoda Susumu, Karube Norihisa, Kimura Kazuo
机构信息
Department of Cardiovascular Surgery, Yokohama City University, School of Medicine, Medical Center, Yokohama, Japan.
出版信息
J Endovasc Ther. 2005 Apr;12(2):258-61. doi: 10.1583/03-1120R.1.
PURPOSE
To report successful endovascular repair of Stanford type A acute aortic dissection associated with a proximally extended dissection of the left main coronary artery.
CASE REPORT
A 71-year-old man presented with acute type A aortic dissection. One day after admission, dissection of the left main coronary artery accompanied by severe myocardial ischemia prompted Palmaz stent placement. Three days later, a customized stent-graft was placed across the entry site of the dissection in the descending aorta. The false lumen in the ascending aorta, transverse arch, and the descending thoracic aorta thrombosed, and the left coronary artery remained patent. At 14 months after the procedures, the patient is doing well and has had no cardiac event.
CONCLUSIONS
This staged procedure may be one option for the management of acute type A aortic dissection complicated by coronary artery dissection.
目的
报告成功对与左主冠状动脉近端扩展型夹层相关的斯坦福A型急性主动脉夹层进行血管内修复。
病例报告
一名71岁男性出现急性A型主动脉夹层。入院一天后，左主冠状动脉夹层伴严重心肌缺血促使置入帕尔马兹支架。三天后，在降主动脉夹层入口处放置了定制的覆膜支架。升主动脉、横弓和降胸主动脉内的假腔形成血栓，左冠状动脉保持通畅。术后14个月，患者情况良好，未发生心脏事件。
结论
这种分期手术可能是治疗合并冠状动脉夹层的急性A型主动脉夹层的一种选择。
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