Kato Koji, Sato Naoki, Fujita Nobuhiko, Yamamoto Takeshi, Iwasaki Yu-Ki, Yodogawa Kenji, Takayama Morimasa, Tanaka Keiji, Takano Teruo
Intensive and Cardiac Care Unit, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan.
J Nippon Med Sch. 2006 Jun;73(3):158-63. doi: 10.1272/jnms.73.158.
Percutaneous aortic valvuloplasty is reportedly a useful tool for the management of critical and severe aortic stenosis with cardiogenic shock. However, early percutaneous coronary intervention for cardiogenic shock is beneficial for elderly patients with acute myocardial infarction. We describe a patient with critical aortic stenosis who presented with severe coronary stenosis of the left main trunk and the ostium of the right coronary artery. We performed percutaneous coronary intervention and percutaneous aortic valvuloplasty under intra-aortic balloon pump and percutaneous cardiopulmonary support. After these procedures, the cardiogenic shock was reversed, and the patient could be weaned from both intra-aortic balloon pump support and percutaneous cardiopulmonary support.
据报道，经皮主动脉瓣成形术是治疗伴有心源性休克的严重主动脉瓣狭窄的一种有用工具。然而，对于急性心肌梗死的老年患者，早期进行经皮冠状动脉介入治疗对心源性休克有益。我们描述了一名患有严重主动脉瓣狭窄的患者，该患者同时伴有左主干和右冠状动脉开口处的严重冠状动脉狭窄。我们在主动脉内球囊泵和经皮心肺支持下进行了经皮冠状动脉介入治疗和经皮主动脉瓣成形术。经过这些操作后，心源性休克得到逆转，患者可以撤离主动脉内球囊泵支持和经皮心肺支持。
