Barca Laura Varela, López-Menéndez José, Palacios Ana Redondo, Stuart Jorge Rodríguez-Roda
Cardiac Surgery Department, Hospital Ramón y Cajal, Madrid, Spain.
Braz J Cardiovasc Surg. 2019 Jan-Feb;34(1):111-113. doi: 10.21470/1678-9741-2018-0029.
We report a case of a 23-year-old man who was diagnosed with Kawasaki disease that progressed to a coronary aneurysm in the left main coronary artery (LMA). He had suffered from acute coronary syndrome and then underwent an emergent percutaneous coronary angioplasty, in which a polyurethane-covered stent was placed inside the aneurysm. The stent was thrombosed one year later, despite the patient had been treated with anticoagulant and antiplatelet therapy. Emergency percutaneous intervention was then performed. LMA was reopened and stent malposition was observed. Therefore, urgent coronary bypass grafting was performed in which a high degree of competitive flow was observed through the reopened stent. LMA was ligated at the inflow of the aneurysm, resulting in an improvement of graft flow. Left main ligature has not been previously reported.
我们报告一例23岁男性，被诊断为川崎病，该病进展为左冠状动脉主干（LMA）的冠状动脉瘤。他曾患急性冠状动脉综合征，随后接受了紧急经皮冠状动脉成形术，在动脉瘤内放置了一个聚氨酯涂层支架。尽管患者接受了抗凝和抗血小板治疗，但一年后支架发生血栓形成。随后进行了紧急经皮介入治疗。LMA重新开通，观察到支架位置不当。因此，进行了紧急冠状动脉搭桥术，术中观察到通过重新开通的支架有高度的竞争性血流。在动脉瘤的流入端结扎LMA，使移植血管血流得到改善。此前尚未有左主干结扎的报道。
