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左冠状动脉起源于肺动脉及大面积肺不张:气道内支架如何挽救生命。

ALCAPA and massive pulmonary atelectasis: how a stent in the airway can be life-saving.

作者信息

Serio Paola, Chiappa Enrico, Fainardi Valentina, Favilli Silvia, Murzi Bruno, Baggi Roberto, Arcieri Luigi, Leone Roberto, Mirabile Lorenzo

机构信息

Respiratory Endoscopy Unit, Department of Paediatric Anesthesia and Intensive Care, Meyer Children Hospital, Florence, Italy.

Pediatric Cardiology Unit, Meyer Children Hospital, Florence, Italy.

出版信息

Int J Pediatr Otorhinolaryngol. 2014 Nov;78(11):2015-7. doi: 10.1016/j.ijporl.2014.08.044. Epub 2014 Sep 6.

Abstract

Anomalous left coronary artery from pulmonary artery (ALCAPA) is a rare congenital anomaly in which left coronary artery arises from the pulmonary artery resulting in progressive myocardial ischemia and dysfunction of the left ventricle. We report a case of ALCAPA with severe cardiac and respiratory failure and huge heart dilation compressing the left main bronchus and preventing from an effective ventilation. Emergency bronchial stenting allowed to improve left lung atelectasis, reduce pulmonary hypertension, resume anterograde left coronary artery perfusion and stabilize cardiovascular conditions to undertake a successful surgical correction.

摘要

异常左冠状动脉发自肺动脉(ALCAPA)是一种罕见的先天性异常,即左冠状动脉发自肺动脉,导致进行性心肌缺血和左心室功能障碍。我们报告一例伴有严重心肺衰竭和巨大心脏扩张的ALCAPA病例,巨大心脏扩张压迫左主支气管,导致无法进行有效通气。紧急支气管支架置入术改善了左肺肺不张,降低了肺动脉高压,恢复了左冠状动脉的顺行灌注,并稳定了心血管状况,从而成功进行了手术矫正。

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