Kajihara N, Sakamoto M, Kan-o M, Ochiai Y, Imoto Y, Miyata K, Yamamoto H, Mouri M, Origuchi H, Sese A
Department of Cardiovascular Surgery, Kyushu Koseinenkin Hospital, Kitakyushu, Japan.
Kyobu Geka. 2007 Sep;60(10):890-4.
From January 2001 to July 2005, 4,741 cardiac catheterizations were performed on adult patients at our institute. Five of them underwent emergency operation due to complications of cardiac catheterization. The causes of operations were acute coronary occlusion due to coronary arterial dissection in 3 patients and bleeding due to perforation of the coronary artery in 2. Intra-aortic balloon pumping was used preoperatively in 4 patients and percutaneous cardio-pulmonary support in 2. Coronary artery bypass grafting was performed on all patients. Perforation sites of the coronary arteries were closed. One patient died 4 months after surgery, due to neurological damage, but the other 4 patients recovered and have been doing well. As coronary artery disruption is one of the main complications of cardiac catheterization, it is necessary to recognize the risk of hemodynamic derangement and to give prompt and appropriate treatment.
2001年1月至2005年7月，我院对成年患者进行了4741例心脏导管插入术。其中5例因心脏导管插入术并发症接受了急诊手术。手术原因包括3例因冠状动脉夹层导致急性冠状动脉闭塞，2例因冠状动脉穿孔出血。4例患者术前使用了主动脉内球囊反搏，2例使用了体外膜肺氧合。所有患者均接受了冠状动脉旁路移植术。冠状动脉穿孔部位均已闭合。1例患者术后4个月因神经损伤死亡，但其他4例患者康复且情况良好。由于冠状动脉破裂是心脏导管插入术的主要并发症之一，有必要认识到血流动力学紊乱的风险并给予及时恰当的治疗。
