Division of Cardiology, Itabashi-chuo Medical Centre, Tokyo, Japan.
Can J Cardiol. 2013 Aug;29(8):1014.e7-9. doi: 10.1016/j.cjca.2012.11.025. Epub 2013 Feb 8.
Mycotic coronary aneurysm formation is a rare complication in patients with infective endocarditis. Furthermore, rupture of coronary artery aneurysm, also rare, is life threatening. Sudden rupture of left main mycotic coronary aneurysm occurred in a patient, aged 68 years, 1 month after root replacement for aortic regurgitation caused by infectious endocarditis. A polytetrafluoroethylene-covered stent was implanted covering the entire aneurysmal portion crossing over the left circumflex coronary artery in this emergent situation. After a successful hemostatic procedure, the patient recovered from cardiogenic shock. We confirmed the sustained patency of the stent segment by coronary angiography 6 months after the procedure.
真菌性冠状动脉瘤形成是感染性心内膜炎患者的一种罕见并发症。此外,冠状动脉瘤破裂也很少见,但危及生命。一位 68 岁的患者在感染性心内膜炎引起的主动脉瓣反流根部置换术后 1 个月时,突发左主干真菌性冠状动脉瘤破裂。在这种紧急情况下,我们使用聚四氟乙烯覆盖的支架植入整个动脉瘤部分,跨越左回旋支冠状动脉。在成功止血后,患者从心源性休克中恢复。我们在术后 6 个月通过冠状动脉造影证实了支架节段的持续通畅。