Mori Kazutaka, Hayakawa Satoko, Yamaguchi Hitoshi, Shimizu Yasuhiro, Suzuki Akihiro, Yamada Takaaki, Suzuki Tomomichi, Yamamoto Harumitsu, Inagaki Masahumi, Tomita Yasushi, Kitano Tomoki
Department of Cardiology, Nagoya Medical Center, 4-1-1 San-no-maru, Naka-ku, Nagoya 460-0001, Japan.
J Cardiol Cases. 2012 Mar 16;5(2):e87-e91. doi: 10.1016/j.jccase.2011.12.004. eCollection 2012 Apr.
A 70-year-old man presented to the emergency department at our hospital with chest pain, 24 months after sirolimus-eluting stents (SESs) were implanted in the proximal left anterior descending coronary artery (LAD), middle right coronary artery (RCA), and middle left circumflex artery (LCX), respectively. Electrocardiogram showed complete right bundle branch block and ST-segment elevation in leads II, III, and aVF. He suddenly went to ventricular tachycardia, followed by ventricular fibrillation. Administration of electrical shock led to cardiac arrest. Immediately, we inserted a percutaneous cardiopulmonary system and intra-aortic balloon pumping. Subsequent emergent coronary angiography showed 100% thrombotic total stent obstruction of triple vessels with thrombolysis in myocardial infarction 0 flow. Thrombectomy and balloon angioplasty were performed at the in-stent thrombotic sites. Despite our intensive care, he died due to heart failure on the third day after hospitalization.
一名70岁男性因胸痛就诊于我院急诊科，其在24个月前分别于左前降支近端冠状动脉（LAD）、右冠状动脉中段（RCA）和左旋支中段（LCX）植入了西罗莫司洗脱支架（SES）。心电图显示完全性右束支传导阻滞，II、III和aVF导联ST段抬高。他突然发生室性心动过速，随后转为心室颤动。电击除颤导致心脏骤停。我们立即插入了经皮心肺系统和主动脉内球囊反搏。随后的急诊冠状动脉造影显示三支血管均出现100%血栓性完全支架阻塞，心肌梗死溶栓分级为0级血流。在支架内血栓形成部位进行了血栓切除术和球囊血管成形术。尽管我们进行了重症监护，但他在住院第三天因心力衰竭死亡。
