Cardiovascular Center, Yokohama City University Medical Center, 232-0024 4-57 Urafunecho, Minamiku, Yokohama, Japan.
Gen Thorac Cardiovasc Surg. 2021 Sep;69(9):1344-1346. doi: 10.1007/s11748-021-01662-w. Epub 2021 Jun 4.
Coronary malperfusion with acute type A aortic dissection is a fatal complication. It is controversial whether to prioritize central repair or coronary reperfusion. Lifesaving becomes even more difficult if a patient has pericardial haemorrhage. Herein, we report a case of acute type A aortic dissection associated with left coronary malperfusion and pericardial haemorrhage, wherein reperfusion of the left coronary artery was performed using only guidewires, and central repair could be performed without major delay. Coronary reperfusion using only guidewires can be a revolutionary therapeutic strategy for this disease.
急性A型主动脉夹层合并冠状动脉灌注不良是一种致命的并发症。对于优先进行中心修复还是冠状动脉再灌注，存在争议。如果患者合并心包积血，抢救就更加困难。在此，我们报告了一例急性 A 型主动脉夹层合并左冠状动脉灌注不良和心包积血的病例，仅使用导丝即可进行左冠状动脉再灌注，且无需大的延迟即可进行中心修复。仅使用导丝进行冠状动脉再灌注可能是该疾病的一种革命性治疗策略。
