Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Ann Thorac Surg. 2020 Feb;109(2):e123-e125. doi: 10.1016/j.athoracsur.2019.06.024. Epub 2019 Jul 27.
Iatrogenic left main coronary artery dissection is a rare entity for cardiac surgery but could cause severe low cardiac output and a catastrophic outcome. There is no conclusive strategy about how to manage such a condition. Here, we report a middle-aged woman who manifested with severe low cardiac output after aortic and mitral valve replacement surgery. She was subsequently diagnosed with extensive left main coronary artery dissection involving the left anterior descending artery and left circumflex artery, which resulted in large extension of myocardial infarction. The complex and dangerous vascular lesion was successfully treated by bailout stenting.
医源性左主干冠状动脉夹层较为罕见，但可导致严重的低心输出量和灾难性后果。对于此类情况，尚无明确的处理策略。本文报告 1 例中年女性，在主动脉瓣和二尖瓣置换术后出现严重的低心输出量。随后诊断为广泛的左主干冠状动脉夹层，累及左前降支和左回旋支，导致大面积心肌梗死扩展。通过紧急支架置入术成功治疗了复杂且危险的血管病变。
