Zena and Michael A. Wiener Cardiovascular Institute, The Mount Sinai Medical Center, New York, New York, USA.
Ann Thorac Surg. 2011 Nov;92(5):1887-9. doi: 10.1016/j.athoracsur.2011.04.095. Epub 2011 Oct 31.
A 52-year-old gentleman with a history of rheumatic fever presented with dyspnea. Transthoracic echocardiography revealed severe valvular aortic stenosis and severe mitral stenosis. A preoperative coronary angiogram revealed an anomalous left circumflex (LCX) artery arising from the right coronary sinus. The patient underwent aortic and mitral valve replacement. Postoperatively, a non-ST segment elevation myocardial infarction developed, and coronary angiography confirmed subtotal occlusion of the anomalous LCX. An emergent reoperation with surgical revascularization was performed. Intraoperatively, the mechanism of injury to the LCX was determined to be compression of the distal LCX by the sewing ring of the two prosthetic valves.
一位 52 岁的男性，有风湿热病史，出现呼吸困难。经胸超声心动图显示严重的主动脉瓣狭窄和严重的二尖瓣狭窄。术前冠状动脉造影显示左回旋支（LCX）异常起源于右冠状动脉窦。患者接受了主动脉瓣和二尖瓣置换术。术后发生非 ST 段抬高型心肌梗死，冠状动脉造影证实异常 LCX 近段完全闭塞。行急诊再次手术并进行血管搭桥。术中确定 LCX 损伤的机制为两个人工瓣膜的缝合环压迫 LCX 远端。
