Apostolakis Efstratios, Tsigkas Grigorios, Baikoussis Nikolaos G, Koniari Ioanna, Alexopoulos Dimitrios
Cardiothoracic surgery Department, Patras University School of Medicine, University Hospital, Patras Greece.
J Cardiothorac Surg. 2010 Aug 19;5:65. doi: 10.1186/1749-8090-5-65.
It is common knowledge that cocaine has been linked to the development of various acute and chronic cardiovascular complications including acute coronary syndromes. We present a young, male patient, drug abuser who underwent CABG due to anterolateral myocardial infarction. Our presentation is one of the very rare cases reported in literature regarding acute thrombosis of left main coronary artery related to cocaine use, in a patient with normal coronary arteries, successfully operated. Drug-abusers seem to have increased mortality and morbidity after surgery and high possibility for stent thrombosis after percutaneous coronary interventions, because of their usually terrible medical compliance and coexistent several problems of general health. There are no specific guidelines about treatment of thrombus formation in coronary arteries, as a consequence of cocaine use. So, any decision making concerning the final treatment of these patient is a unique and individualized approach. We strongly recommend that all these patients should be treated surgically, especially patients with thrombus into the left main artery.
众所周知,可卡因与包括急性冠状动脉综合征在内的各种急慢性心血管并发症的发生有关。我们介绍一位年轻男性药物滥用者,他因前外侧心肌梗死接受了冠状动脉旁路移植术(CABG)。我们的病例是文献中报道的非常罕见的情况之一,即一名冠状动脉正常的患者因使用可卡因导致左主干冠状动脉急性血栓形成,并成功进行了手术。由于药物滥用者通常医疗依从性很差且存在多种全身健康问题,他们术后的死亡率和发病率似乎会增加,经皮冠状动脉介入治疗后发生支架血栓形成的可能性也很高。对于因使用可卡因导致冠状动脉血栓形成的治疗,目前尚无具体指南。因此,针对这些患者的最终治疗做出的任何决策都是独特的个体化方法。我们强烈建议所有这些患者应接受手术治疗,尤其是左主干动脉有血栓的患者。