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支架断裂和左心室假性动脉瘤的罕见病例 - 心脏结核背景下的罕见关联。

A curious case of stent fracture and left ventricular pseudoaneurysm - A rare association in the background of cardiac tuberculosis.

机构信息

Department of Cardiology, 29354SCTIMST, India.

出版信息

Trop Doct. 2021 Oct;51(4):594-595. doi: 10.1177/00494755211017422. Epub 2021 May 27.

Abstract

Cardiac involvement in tuberculosis mainly affects the pericardium, with the myocardium being rarely involved. Coronary stent infection in patients with tuberculosis is rarely described. Myocardial involvement in tuberculosis can lead to complications such as ventricular granuloma, or dysrhythmias. Here, we present the case of a 60-year-old gentleman who had a history of multiple percutaneous coronary angioplasty, and pericardiectomy for constrictive tubercular pericardial effusion. Nine months after surgery, he presented with a left ventricular pseudoaneurysm and multiple stent fractures in the right coronary artery. Myocardial involvement in tuberculosis can cause ventricular pseudoaneurysms due to contiguous involvement from the pericardium. Stent fractures are commonly associated with pyogenic infections but can occur in cardiac tuberculosis. The occurrence of a stent fracture and ventricular pseudoaneurysm in the background of cardiac tuberculosis is, however, very rare. Patients with a history of cardiac tuberculosis should always be followed for late sequelae and complications, which may be bizarre.

摘要

肺结核可累及心脏,主要影响心包,很少累及心肌。肺结核患者冠状动脉支架感染罕见。肺结核累及心肌可导致心室肉芽肿或心律失常等并发症。本文报道了 1 例 60 岁男性,既往有多次经皮冠状动脉成形术和心包切除术治疗缩窄性结核性心包积液。术后 9 个月,患者出现左心室假性动脉瘤和右冠状动脉多支架断裂。肺结核累及心肌可导致心室假性动脉瘤,这是由于与心包的连续性累及。支架断裂通常与化脓性感染有关,但也可发生于心脏结核。然而,心脏结核背景下发生支架断裂和心室假性动脉瘤非常罕见。有心脏结核病史的患者应始终随访,以发现可能很奇特的晚期后遗症和并发症。

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