慢性完全闭塞病变经皮冠状动脉介入治疗继发冠状动脉动静脉瘘

Narasimhan Seshasayee

Manning Rural Referral Hospital, Cardiovascular Division, Department of Medicine, Hunter New England Health Services, Taree, NSW 2430, Australia ; Conjoint Senior Lecturer, University of New England, School of Rural Medicine, Armidale, NSW 2351, Australia ; Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, AB, Canada.

Case Rep Vasc Med. 2013;2013:706820. doi: 10.1155/2013/706820. Epub 2013 Jun 20.

This is a case report of a 61-year-old female presenting with ongoing chest pain in the setting of an NSTEMI with lateral ST-T changes. On attempting to open the left circumflex (LCX), it resulted in a proximal LCX dissection. The patient remained stable with no further chest pain. She was treated with IV Eptifibatide for 48 hours and restudied in 72 hours. Repeat coronary angiography showed a marginally improved proximal dissection plane with a coronary AV fistula. She was managed conservatively and discharged with a non-invasive assessment in 8 weeks. The patient had a negative stress echocardiogram and was managed with maximal medical therapy.

这是一例61岁女性的病例报告，该患者在非ST段抬高型心肌梗死（NSTEMI）伴侧壁ST-T改变的情况下持续出现胸痛。在试图开通左旋支（LCX）时，导致了LCX近端夹层。患者病情保持稳定，未再出现胸痛。她接受了48小时的静脉注射依替巴肽治疗，并在72小时后再次进行检查。重复冠状动脉造影显示近端夹层平面略有改善，并伴有冠状动脉动静脉瘘。她接受了保守治疗，并在8周后进行无创评估后出院。该患者负荷超声心动图结果为阴性，并接受了最大程度的药物治疗。