Mori T, Hiranaka T, Nomura F, Kurozumi K, Yagura A
Department of Cardiovascular Surgery, Kinan General Hospital.
Kyobu Geka. 1992 May;45(5):428-31.
We report here two cases in which patients fell into pulmonary edema due to ischemic mitral regurgitation (ischemic MR) after cardiac catheterization and underwent emergency coronary artery bypass grafting (CABG) using an intra-aortic balloon pumping. The patient were a 65-year-old man and a 80-year-old woman, and both had a chief complaint of angina after myocardiac infarction. In both cases, coronary angiography revealed triple vessel disease, and left ventriculography showed severe MR. However echocardiography, when they were hospitalized, did not show significant MR. Therefore we thought that they had gone into congestive heart failure because cardiac ischemia and volume load following cardiac catheterization provoked MR. In fact, postoperative left ventriculography and echocardiography showed decreased MR. We now think that it is important to keep in mind the cases of severe ischemic MR for which CABG alone is adequate treatment and to evaluate ischemic MR not only by left ventriculography but also by echocardiography.
我们在此报告两例患者，他们在心脏导管插入术后因缺血性二尖瓣反流（缺血性MR）而陷入肺水肿，并使用主动脉内球囊泵进行了急诊冠状动脉旁路移植术（CABG）。患者为一名65岁男性和一名80岁女性，两人均以心肌梗死后心绞痛为主诉。在这两例病例中，冠状动脉造影显示三支血管病变，左心室造影显示严重MR。然而，入院时的超声心动图并未显示明显的MR。因此，我们认为他们因心脏导管插入术后的心脏缺血和容量负荷诱发了MR，从而陷入了充血性心力衰竭。事实上，术后左心室造影和超声心动图显示MR减轻。我们现在认为，对于仅行CABG即为充分治疗的严重缺血性MR病例，牢记这些病例并不仅通过左心室造影，还通过超声心动图评估缺血性MR很重要。
