Department of Cardiovascular Sciences, Centro Cardiologico Monzino, IRCCS, University of Milan, Milan, Italy.
Ann Thorac Surg. 2010 Mar;89(3):953-5. doi: 10.1016/j.athoracsur.2009.08.024.
Left main coronary artery occlusion occurred immediately after transfemoral aortic valve implantation in an 87-year-old woman, which resulted in ventricular fibrillation and hemodynamic collapse. This life-threatening complication was promptly diagnosed with transesophageal echocardiography, which showed the disappearance of diastolic left main coronary artery jet flow and was confirmed with aortic root angiography. After prompt defibrillation, hemodynamic support was obtained with intra-aortic balloon pump and inotropic drugs. Functional recovery and survival were achieved with coronary stenting. This report highlights the importance of an integrated team approach of highly skilled specialists for these novel interventions.
一位 87 岁女性在行经股动脉主动脉瓣置换术后即刻发生左主干冠状动脉闭塞，导致室颤和血流动力学崩溃。经食管超声心动图迅速诊断出这种危及生命的并发症，显示舒张期左主干冠状动脉射流消失，并经主动脉根部造影证实。迅速除颤后，通过主动脉内球囊泵和正性肌力药物维持血流动力学支持。冠状动脉支架置入术实现了功能恢复和生存。本报告强调了由高技能专家组成的综合团队对这些新型介入治疗的重要性。
