Department of Cardiology, CHU de Caen, Caen, France.
Korean Circ J. 2012 Jul;42(7):504-6. doi: 10.4070/kcj.2012.42.7.504. Epub 2012 Jul 26.
Although rare, iatrogenic aortocoronary dissection is one of the complications most dreaded by the interventional cardiologist. If not managed promptly, it can have redoubted and serious consequences. Herein, we present the case of a 70 year-old woman who was treated by stenting of the second segment of the right coronary artery (RCA) for recurrent angina but, unfortunately, the procedure was complicated by anterograde dissection of the RCA with a simultaneous retrograde propagation to the proximal part of the ascending aorta. Successful stenting of the entry point was able to recuperate the RCA and to limit the retrograde propagation to the ascending aorta, but there was an extension of the dissection to the aortic valve leaflets resulting in a massive aortic insufficiency. Therefore, surgical aortic valve replacement with prosthetic tube graft was performed [corrected].
虽然罕见，但医源性冠状动脉夹层是介入心脏病学家最害怕的并发症之一。如果不及时处理，可能会产生严重的后果。在此，我们介绍了一位 70 岁女性的病例，她因反复发作的心绞痛而行右冠状动脉（RCA）第二段支架置入术，但不幸的是，该手术并发 RCA 顺行夹层，同时逆行传播至升主动脉近端。成功地对入口点进行支架置入术恢复了 RCA 的通畅，并限制了逆行传播至升主动脉，但夹层延伸至主动脉瓣叶导致大量主动脉瓣关闭不全。因此，行主动脉瓣置换术及带瓣人造血管移植。
