Chowdhury Ujjwal Kumar, Chauhan Abhinav Singh, Kapoor Poonam Malhotra, Hasija Suruchi, Jagia Priya, Ramakrishnan Pradeep
Department of Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, New Delhi, India.
Department of Cardiovascular Anaesthesia, All India Institute of Medical Sciences, New Delhi, India.
Ann Card Anaesth. 2017 Oct-Dec;20(4):444-446. doi: 10.4103/aca.ACA_79_17.
A 50-year-old woman with rheumatic heart disease, mitral stenosis, and critical isolated left main ostial stenosis was successfully treated by mitral valve replacement, tricuspid annuloplasty, and surgery of left main osteoplasty and is reported for its rarity. Notable clinical findings included an intermittently irregular pulse, blood pressure of 100/70 mmHg, cardiomegaly, a diastolic precordial thrill, a mid-diastolic murmur without presystolic accentuation that was loudest at the mitral area. Chest radiograph revealed cardiomegaly with a cardiothoracic ratio of 0.7 due to enlarged right atrium, right ventricle with a straightened left heart border and evidence of pulmonary hypertension. The investigation shows that surgical reconstruction of the left main coronary artery is safe and effective for the treatment.
一名50岁患有风湿性心脏病、二尖瓣狭窄和严重孤立性左主冠状动脉口狭窄的女性患者，成功接受了二尖瓣置换术、三尖瓣环成形术以及左主冠状动脉成形术，因其罕见性而被报道。显著的临床发现包括间歇不规则脉搏、血压100/70 mmHg、心脏扩大、舒张期心前区震颤、二尖瓣区最响亮的舒张中期杂音且无收缩期前增强。胸部X线片显示由于右心房、右心室扩大，心脏扩大，心胸比率为0.7，左心缘变直并有肺动脉高压迹象。调查表明，左主冠状动脉的手术重建治疗是安全有效的。
