Watanabe Hirotoshi, Saito Naritatsu, Tatsushima Syojiro, Tazaki Junichi, Toyota Toshiaki, Imai Masao, Watanabe Shin, Yamamoto Erika, Bao Bingyuan, Nakatsuma Kenji, Watanabe Hiroki, Shizuta Satoshi, Kimura Takeshi
Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan.
J Invasive Cardiol. 2015 Jul;27(7):E139-42.
Percutaneous coronary intervention (PCI) for anomalous coronary arteries is often difficult because the support provided by the guide catheter is insufficient. We encountered a patient with severe three-vessel coronary disease including a totally occluded anomalous right coronary artery (RCA) originating from the left sinus of Valsalva. Initial PCI for the anomalous RCA via the transradial approach failed. Therefore, we constructed a three-dimensional (3D) aortocoronary model and conducted an in vitro simulation to plan the second PCI and found that a Judkins left (JL) 3.5 guide catheter in the power position yielded maximum backup support for the anomalous RCA. Thus, the second PCI was conducted using an 8 Fr JL 3.5 guide catheter in the power position via the transfemoral approach. The procedure was smooth and successful, without any adverse events. Our experience suggests that case-specific 3D models are useful for strategic planning of complex PCIs.
经皮冠状动脉介入治疗（PCI）用于异常冠状动脉时通常很困难，因为引导导管提供的支撑不足。我们遇到一名患有严重三支血管冠状动脉疾病的患者，其中包括一条起源于左冠状动脉窦的完全闭塞的异常右冠状动脉（RCA）。最初经桡动脉途径对异常RCA进行的PCI失败。因此，我们构建了一个三维（3D）主动脉冠状动脉模型并进行了体外模拟以规划第二次PCI，发现处于动力位的Judkins左（JL）3.5引导导管可为异常RCA提供最大的支撑。于是，第二次PCI通过经股动脉途径使用处于动力位的8 Fr JL 3.5引导导管进行。手术过程顺利且成功，未发生任何不良事件。我们的经验表明，针对具体病例的3D模型有助于复杂PCI的策略规划。
