Park Hyung Seo, Park Jae-Hyeong, Jeong Jin-Ok
Division of Cardiology, Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea.
J Cardiovasc Ultrasound. 2009 Dec;17(4):145-7. doi: 10.4250/jcu.2009.17.4.145. Epub 2009 Dec 31.
Cardiac myxomas are the most common benign cardiac tumors and can be associated with systemic embolization including acute myocardial infarction (AMI). The probability of an arterial embolization is closely related to a tumor's villous morphology. In cases of AMI caused by cardiac myxoma, open heart surgery including excision of the coronary artery has been the one of the treatment options for removing the myxoma and embolus from the coronary artery to maintain distal coronary flow. However, preparing for emergent open heart surgery takes a considerable amount of time. Moreover, this time delay can deteriorate the coronary perfusion to the infarcted area and is associated with poor clinical prognosis. So intracoronary catheter aspiration can be an additional option to maintain the distal coronary flow. In this report we present a case with acute anterior ST elevation myocardial infarction caused by a left atrial myxoma. The embolus in the left anterior descending coronary artery was successfully removed with intracoronary catheter aspiration, and distal coronary flow was restored after the procedure.
心脏黏液瘤是最常见的心脏良性肿瘤,可伴有包括急性心肌梗死(AMI)在内的全身栓塞。动脉栓塞的可能性与肿瘤的绒毛形态密切相关。在心脏黏液瘤引起的AMI病例中,包括冠状动脉切除术在内的心脏直视手术一直是从冠状动脉中切除黏液瘤和栓子以维持冠状动脉远端血流的治疗选择之一。然而,准备紧急心脏直视手术需要相当长的时间。此外,这种时间延迟会使梗死区域的冠状动脉灌注恶化,并与不良的临床预后相关。因此,冠状动脉内导管抽吸可以作为维持冠状动脉远端血流的另一种选择。在本报告中,我们介绍了一例由左心房黏液瘤引起的急性前壁ST段抬高型心肌梗死病例。通过冠状动脉内导管抽吸成功清除了左前降支冠状动脉内的栓子,术后冠状动脉远端血流得以恢复。