Sunagawa Osahiko, Nakamura Makiko, Hokama Ryo, Miyara Takafumi, Taba Yoji, Touma Takashi
Department of Cardiology, Okinawa Prefectural Nanbu Medical Center and Children's Medical Center, 118-1 Arakawa, Haebaru-cho, Okinawa, 901-1193, Japan.
Cardiovasc Interv Ther. 2017 Apr;32(2):146-150. doi: 10.1007/s12928-016-0379-z. Epub 2016 Feb 5.
A 55-year-old man had undergone mitral annuloplasty for mitral regurgitation with posterior mitral prolapse 3 years prior. He was examined at our hospital for dyspnea and fatigue. A coronary angiogram revealed iatrogenic chronic total occlusion (CTO) in the left circumflex coronary artery. We performed percutaneous coronary intervention (PCI) and successfully placed an everolimus-eluting stent. An intravascular ultrasound (IVUS) showed an impaired coronary artery at the occlusion site. To our knowledge, this is the first reported successful PCI for iatrogenic CTO after mitral valve repair. IVUS-guided PCI may help prevent complications in unusual CTO cases, such as coronary rupture.
一名55岁男性3年前因二尖瓣后叶脱垂伴二尖瓣反流接受了二尖瓣环成形术。他因呼吸困难和疲劳在我院接受检查。冠状动脉造影显示左旋支冠状动脉医源性慢性完全闭塞（CTO）。我们进行了经皮冠状动脉介入治疗（PCI），并成功植入了依维莫司洗脱支架。血管内超声（IVUS）显示闭塞部位冠状动脉受损。据我们所知，这是二尖瓣修复术后医源性CTO首例成功PCI的报道。IVUS引导下的PCI可能有助于预防不寻常CTO病例中的并发症，如冠状动脉破裂。
