Wang Fangfang, Han Jiangli, Guo Lijun
Department of Cardiology and Institute of Vascular Medicine, Peking University Third Hospital.
NHC Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides.
Medicine (Baltimore). 2020 Feb;99(7):e19163. doi: 10.1097/MD.0000000000019163.
Woven coronary artery is a very rare congenital anomaly which may lead to acute coronary syndrome in previous literatures. At present, there is no consensus on the treatment of this coronary artery abnormality.
A 48-year-old male was admitted to the other hospital because of persistent chest pain. The electrocardiogram showed an ST-segment elevation in the v1-v5 lead and the patient was diagnosed with acute anterior myocardial infarction. Coronary angiography revealed 2 lumens in the proximal segment of the left anterior descending artery. Then the patient was transferred to our hospital for further diagnosis and treatment.
The patient was diagnosed with acute myocardial infarction and woven coronary. Transthoracic echocardiography showed left ventricular anterior wall segmental motor abnormalities.
Optical coherence tomography (OCT) and fractional flow reserve (FFR) guided percutaneous coronary intervention was performed successfully.
During the follow-up period of 4 years, the patient remained asymptomatic and no adverse events.
Although the significance of blood flow limitation in one of the lumens detected by FFR is unclear, this strategy of OCT and FFR-guided treatment in woven coronary artery combined with acute coronary events still shows its feasibility.
编织状冠状动脉是一种非常罕见的先天性异常，在以往文献中可能导致急性冠状动脉综合征。目前，对于这种冠状动脉异常的治疗尚无共识。
一名48岁男性因持续性胸痛入住其他医院。心电图显示V1-V5导联ST段抬高，患者被诊断为急性前壁心肌梗死。冠状动脉造影显示左前降支近端有2个管腔。随后患者转至我院进一步诊治。
患者被诊断为急性心肌梗死和编织状冠状动脉。经胸超声心动图显示左心室前壁节段性运动异常。
成功进行了光学相干断层扫描（OCT）和血流储备分数（FFR）引导下的经皮冠状动脉介入治疗。
在4年的随访期内，患者无症状，未发生不良事件。
尽管FFR检测到的其中一个管腔血流受限的意义尚不清楚，但这种OCT和FFR引导下治疗编织状冠状动脉合并急性冠状动脉事件的策略仍显示出其可行性。
