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经皮冠状动脉介入治疗期间导管诱发的主动脉冠状动脉夹层:主动脉开口处支架置入成功

Catheter induced aortocoronary dissection during percutaneous coronary intervention: successful aortoostial stenting.

作者信息

Gürdal Ahmet, Yıldız Süleyman Sezai, Kılıçkesmez Kadriye

机构信息

Department of Cardiology, University of Health Sciences, Şişli Hamidiye Etfal Training and Research Hospital, İstanbul, Turkey.

出版信息

Turk Kardiyol Dern Ars. 2018 Jan;46(1):57-60. doi: 10.5543/tkda.2017.88865.

Abstract

Iatrogenic acute dissection of the ascending aorta is a serious but rare complication of cardiac catheterization and percutaneous coronary intervention (PCI). Although treatment of ascending aortic dissection may require surgical repair, stenting at the origin of the dissection area may be sufficient in aortocoronary dissection (AD) following PCI. Described is the case of a 64-year-old female patient who was treated with PCI for a critical lesion of the right coronary artery (RCA). Immediate stenting at the source of the dissection was sufficient to repair the RCA lesions and successfully seal the site of retrograde propagation of the dissection. The ascending aortic dissection was monitored with computed tomography and the dissection was spontaneously repaired within 72 hours.

摘要

医源性升主动脉夹层是心脏导管插入术和经皮冠状动脉介入治疗(PCI)的一种严重但罕见的并发症。尽管升主动脉夹层的治疗可能需要手术修复,但在PCI术后的主动脉冠状动脉夹层(AD)中,在夹层区域的起始处进行支架置入可能就足够了。本文描述了一名64岁女性患者的病例,该患者因右冠状动脉(RCA)的严重病变接受了PCI治疗。在夹层源头立即进行支架置入足以修复RCA病变,并成功封闭夹层逆行扩展的部位。通过计算机断层扫描对升主动脉夹层进行监测,夹层在72小时内自行修复。

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