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经皮冠状动脉介入治疗(PCI)后出现右冠状动脉巨大假性动脉瘤的血管性白塞病:一例报告

[Vascular Behçet disease presenting large right coronary artery pseudoaneurysm after percutaneous coronary intervention( PCI): report of a case].

作者信息

Komooka Masatoshi, Higashiue Shinichi, Matsubayashi Keiji, Tonda Hisashi, Kawahira Toshihiro, Azuma Shuhei, Hiramatsu Norihiko, Furuya Onichi

机构信息

Department of Cardiovascular Surgery, Kishiwada Tokusyukai Hospital, Kishiwada, Japan.

出版信息

Kyobu Geka. 2013 Aug;66(9):845-8.

Abstract

A 37-year-old man was diagnosed with angina pectoris and underwent percutaneous coronary intervention(PCI) procedure for right coronary artery in other hospital. Five months after PCI procedure, he was admitted to the hospital because of fever, chest pain and respiratory discomfort. He was diagnosed as having a large right coronary artery pseudoaneurysm which was about 40 mm in diameter. He was transfered to our hospital. We did coronary artery bypass grafting(CABG)[ saphenous vein graft (SVG)-#3] and pseudoaneurysm closure, and he left our hospital on 37 post-operative day. After discharge from our hospital, he developed iliocecal ulcer, oral aphtha, folliculitis and arthralgia and was diagnosed with Behçet disease. Seven months after the 1st surgery, proximal anastomosis site of SVG was ruptured and presented huge ascending aorta pseudoaneurysm. We performed autologous pericardial patch plasty on ascending aorta, and covered there with omentum flap. He uneventfully left our hospital on 19 post-operative day.

摘要

一名37岁男性被诊断为心绞痛,并在其他医院接受了右冠状动脉的经皮冠状动脉介入治疗(PCI)。PCI术后五个月,他因发热、胸痛和呼吸不适入院。他被诊断为患有直径约40毫米的巨大右冠状动脉假性动脉瘤。他被转诊至我院。我们进行了冠状动脉旁路移植术(CABG)[大隐静脉移植(SVG)-#3]和假性动脉瘤闭合术,他在术后第37天出院。出院后,他出现了回盲部溃疡、口腔溃疡、毛囊炎和关节痛,并被诊断为白塞病。第一次手术后七个月,SVG的近端吻合部位破裂,出现巨大的升主动脉假性动脉瘤。我们对升主动脉进行了自体心包补片成形术,并用网膜瓣覆盖。他在术后第19天顺利出院。

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