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右肺切除术后急性心脏疝导致的下壁急性心肌梗死

Inferior acute myocardial infarction due to acute cardiac herniation after right pneumonectomy.

作者信息

Terauchi Yasunobu, Kitaoka Hiroaki, Tanioka Katsutoshi, Kubo Toru, Imamura Shunichi, Baba Yuichi, Kawada Yasumasa, Noguchi Tatsuya, Okawa Makoto, Yamasaki Naohito, Yabe Toshikazu, Doi Yoshinori

机构信息

Department of Medicine and Geriatrics, Kochi Medical School, Kohasu, Oko-cho, Nankoku, Kochi, Japan.

出版信息

Cardiovasc Interv Ther. 2012 May;27(2):110-3. doi: 10.1007/s12928-011-0089-5. Epub 2012 Feb 28.

Abstract

A 69-year-old man underwent right intrapericardial pneumonectomy for lung cancer. After 24 h, he went into shock with inferior acute myocardial infarction. We performed urgent coronary angiography, which revealed total occlusion of the mid-right coronary artery. Intravascular ultrasound showed that the artery seemed to be compressed from the pericardial side. We implanted a coronary stent because the lesion was refractory to balloon dilatation. After the procedure, we performed computed tomography and cardiac herniation was diagnosed. Emergency thoracotomy was performed to return the herniated heart to its normal position. This patient was discharged 38 days after initial surgery.

摘要

一名69岁男性因肺癌接受了右心包内肺切除术。术后24小时,他因急性下壁心肌梗死而休克。我们进行了紧急冠状动脉造影,结果显示右冠状动脉中段完全闭塞。血管内超声显示该动脉似乎受到心包侧的压迫。由于病变对球囊扩张治疗无效,我们植入了冠状动脉支架。术后,我们进行了计算机断层扫描,并诊断为心脏疝。于是进行了急诊开胸手术,将疝出的心脏恢复到正常位置。该患者在初次手术后38天出院。

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