Ma Gui-Zhou, Wang Ying, Xu Rong-He, Cai Zhi-Xiong
Acta Cardiol. 2016 Apr;71(2):127-34. doi: 10.2143/AC.71.2.3141841.
Total occlusion of the left main coronary artery (LMCA) is a rare but clinically serious event due to its poor prognosis. While coronary artery bypass grafting (CABG) is currently recommended for treatment of these patients, recent studies support the feasibility of treatment by percutaneous intervention (PCI). Here, we report the diagnoses and treatment of two cases of total occlusion of the LMCA. One patient presented with acute myocardial infarction complicated by cardiogenic shock resulting from acute occlusion of the LMCA, and the other patient presented with unstable angina pectoris resulting from chronic occlusion of the LMCA. Both cases were successfully treated with PCI. Our results in these cases suggest that PCI may be a safe and effective alternative to CABG for treatment of LMCA occlusion.
左冠状动脉主干（LMCA）完全闭塞是一种罕见但临床后果严重的事件，因其预后较差。虽然目前推荐冠状动脉旁路移植术（CABG）用于治疗这些患者，但近期研究支持经皮介入治疗（PCI）的可行性。在此，我们报告两例LMCA完全闭塞的诊断和治疗情况。一例患者因LMCA急性闭塞出现急性心肌梗死并并发心源性休克，另一例患者因LMCA慢性闭塞出现不稳定型心绞痛。两例均通过PCI成功治疗。我们在这些病例中的结果表明，对于LMCA闭塞的治疗，PCI可能是CABG的一种安全有效的替代方法。
