Abuzahra Mohammed M, Mesa Andres, Treistman Bernardo
Department of Cardiology, Baylor College of Medicine and the Texas Heart Institute at St. Luke's Episcopal Hospital, Houston, Texas 77030, USA.
Tex Heart Inst J. 2007;34(4):479-84.
Medical therapy alone often insufficiently alters the clinical course of patients who have experienced acute myocardial infarction and concomitant cardiogenic shock, and in whom the left main coronary artery is the culprit vessel. Emergency coronary artery bypass grafting is an effective yet time-consuming approach that entails the risk of extensive, irreversible myocardial damage. Percutaneous coronary intervention in the unprotected left main coronary artery can enable initial revascularization and rapid stabilization even in high-risk patients, but outcomes from the procedure since the recent advent of drug-eluting stents are still being determined. Herein, we report the successful deployment of a sirolimus-eluting stent in a 65-year-old man who had experienced acute myocardial infarction and cardiogenic shock consequent to an occluded left main coronary artery. The patient recovered rapidly and completely. We review the medical literature and compare percutaneous coronary intervention with other methods of treatment.
对于经历过急性心肌梗死并伴有心源性休克且左主干冠状动脉为罪犯血管的患者，单纯药物治疗往往不足以改变其临床病程。急诊冠状动脉旁路移植术是一种有效但耗时的方法，存在广泛、不可逆心肌损伤的风险。在无保护的左主干冠状动脉中进行经皮冠状动脉介入治疗，即使在高危患者中也能实现初始血管重建和快速稳定，但自药物洗脱支架问世以来该手术的结果仍有待确定。在此，我们报告了一例65岁男性患者，其因左主干冠状动脉闭塞导致急性心肌梗死和心源性休克，成功植入了西罗莫司洗脱支架。患者迅速且完全康复。我们回顾了医学文献，并将经皮冠状动脉介入治疗与其他治疗方法进行了比较。
