Mehta P K, Samady H, Vassiliades T A, Book W M
Division of Cardiology, Emory University School of Medicine, 1639 Pierce Drive, WMB 319, Atlanta, GA 30322, USA.
Pediatr Cardiol. 2008 Sep;29(5):957-61. doi: 10.1007/s00246-007-9157-0. Epub 2007 Dec 1.
Patients with systemic lupus erythematosus (SLE) may present with acute coronary syndrome (ACS) due to coronary vasculitis or premature atherosclerosis. There is a paucity of data on invasive management strategies for young adults who present with an ACS secondary to active vasculitis. This article describes the case of a teenager who presented with an ACS secondary to lupus vasculitis as his first presentation of active SLE. Coronary angiography showed a left main equivalent lesion involving a proximal very large left anterior descending artery (LAD) and diagonal stenosis (with a diminutive left circumflex artery). The boy underwent a successful endoscopic coronary bypass surgery to his LAD followed by percutaneous coronary intervention to his diagonal artery. This case demonstrates the feasibility and safety of a hybrid coronary revascularization in a teenager with acute coronary syndrome due to coronary vasculitis.
系统性红斑狼疮（SLE）患者可能因冠状动脉血管炎或过早发生动脉粥样硬化而出现急性冠状动脉综合征（ACS）。对于继发于活动性血管炎的ACS年轻成人患者，关于侵入性管理策略的数据较少。本文描述了一名青少年患者的病例，该患者以继发于狼疮血管炎的ACS作为活动性SLE的首次表现。冠状动脉造影显示左主干等同病变，累及近端非常粗大的左前降支动脉（LAD）和对角支狭窄（左旋支动脉细小）。该男孩对其LAD成功进行了内镜下冠状动脉搭桥手术，随后对其对角支动脉进行了经皮冠状动脉介入治疗。该病例证明了在因冠状动脉血管炎导致急性冠状动脉综合征的青少年患者中进行杂交冠状动脉血运重建的可行性和安全性。
