Cardiovascular Research, Hospital of San Giovanni, Bellinzona, 6500, Switzerland.
Internal Medicine, Hospital of San Giovanni, Bellinzona, 6500, Switzerland.
ESC Heart Fail. 2020 Apr;7(2):714-720. doi: 10.1002/ehf2.12626. Epub 2020 Jan 29.
Coronary fibromuscular dysplasia is uncommon, and even rarer its unstable and recurrent course. We present the unique case of a 52-year-old woman who underwent in total 12 coronary angiographies and three percutaneous coronary intervention within 24 months because of repetitive acute coronary syndromes due to refractory spasm, dissection, restenosis all leading to end-stage heart failure, and heart transplantation. The patient died 12 days after the heart transplantation complicated by intraoperative acute thrombotic occlusion of left anterior descending artery of the graft despite normal pretransplant coronary angiography. Autopsy of the recipient heart confirmed coronary fibromuscular dysplasia with massive intimal hyperplasia and restenosis.
冠状动脉肌纤维发育不良并不常见，其不稳定且反复发作的病程更为罕见。我们报告了一例 52 岁女性的独特病例，该患者在 24 个月内总共进行了 12 次冠状动脉造影和 3 次经皮冠状动脉介入治疗，原因是由于难治性痉挛、夹层、再狭窄导致的反复发作的急性冠状动脉综合征，最终导致终末期心力衰竭和心脏移植。尽管移植前的冠状动脉造影正常，但该患者在心脏移植后 12 天死于移植心脏的左前降支术中急性血栓闭塞。受体心脏的尸检证实为冠状动脉肌纤维发育不良，伴有大量内膜增生和再狭窄。
