Department of Cardiology, Instituto de Cardiologia, Hospital São Francisco, Belo Horizonte, MG, Brazil.
Catheter Cardiovasc Interv. 2010 Feb 1;75(2):225-8. doi: 10.1002/ccd.22300.
We report an 84-year-old patient who suddenly developed nausea, vomiting, hypotension, and needed intubation, assisted ventilation and pharmacological vasopressor support. Admission EKG showed anterior and lateral leads ST segment depression and 2 mm ST segment elevation in avR lead. Angiogram showed unprotected left-main coronary-artery (LM) sub-occlusive disease and totally occluded ostial right-coronary-artery (RCA), distally filled through the left-coronary system. Unprotected LM disease was immediately treated with bare metal stent. The stent jailed the left-circunflex coronary-artery (LCx) ostium but did not compromise the arterial flow. Lately, the patient was discharged in a very good health condition. Ten months angiographic follow-up showed an extremely compromised LCx ostium treated successfully with drug eluted stent (DES) and mid left anterior descendent (LAD) severe lesion, treated with DES.
我们报告了一位 84 岁的患者，他突然出现恶心、呕吐、低血压，需要插管、辅助通气和药物升压支持。入院心电图显示前侧和外侧导联 ST 段压低，avR 导联 ST 段抬高 2mm。血管造影显示无保护的左主干冠状动脉（LM）亚闭塞性病变和完全闭塞的右冠状动脉（RCA）开口，通过左冠状动脉系统远端充盈。无保护的 LM 病变立即用裸金属支架治疗。支架夹住了左回旋支冠状动脉（LCx）开口，但没有影响动脉血流。最近，患者出院时身体状况非常好。10 个月的血管造影随访显示，LCx 开口严重狭窄，采用药物洗脱支架（DES）成功治疗，中段前降支（LAD）严重病变，采用 DES 治疗。
