Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, District of Columbia.
Department of Medicine, MedStar Washington Hospital Center, Washington, District of Columbia.
Catheter Cardiovasc Interv. 2021 May 1;97(6):1218-1220. doi: 10.1002/ccd.29333. Epub 2020 Oct 17.
Congenital left main (LM) coronary artery to right atrium fistulas with progression to aneurysm development are rare. Most patients remain asymptomatic, but for those with progressive symptoms, intervention is required. However, there are potential life-threatening complications associated with surgical intervention. We present a case of an extremely rare markedly aneurysmal LM to right atrial fistula treated with surgical ligation complicated by inferolateral ST-elevation myocardial infarction several days post-operatively treated successfully using mechanical aspiration thrombectomy, a stent-retriever, balloon angioplasty, and subsequent intravascular ultrasound-guided percutaneous coronary intervention with drug-eluting stent.
先天性左主干（LM）冠状动脉至右心房瘘伴动脉瘤发展罕见。大多数患者无症状，但对于那些有进行性症状的患者，需要进行干预。然而，手术干预可能会导致潜在的危及生命的并发症。我们报告了一例极其罕见的显著动脉瘤性左主干至右心房瘘，采用手术结扎治疗，术后数天并发下外侧 ST 段抬高心肌梗死，成功采用机械血栓抽吸、支架取栓、球囊血管成形术和随后的血管内超声引导经皮冠状动脉介入治疗，使用药物洗脱支架。
