Department of Cardiothoracic Surgery, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia.
Department of Interventional Cardiology, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia.
J Card Surg. 2021 Dec;36(12):4766-4769. doi: 10.1111/jocs.16000. Epub 2021 Sep 19.
A patient has presented with type A aortic dissection and computed tomography aortogram revealed proximal and distal aorta intimointimal intussusception.
MATERIAL & METHODS: The patient has undergone successful aortic root replacement surgery and on the way to his recovery, he developed inferolateral myocardial infarction with the troponin I leak.
The coronary angiogram showed a small contrast leak around the left button with no luminal compromise.
An intravascular ultrasound played a major part in the diagnosis of left main coronary artery compression due to the intramural hematoma. A drug-eluting stent was deployed to relieve the compression and to support the dissected layers of the coronary artery.
患者出现 A 型主动脉夹层,计算机断层扫描主动脉造影显示近端和远端主动脉内膜-中膜内陷。
患者成功接受了主动脉根部置换手术,在康复过程中,他出现了肌钙蛋白 I 漏的下外侧心肌梗死。
冠状动脉造影显示左冠状动脉瓣周围有小的造影剂渗漏,但管腔无狭窄。
血管内超声在诊断左主干冠状动脉受压方面起了主要作用,这是由于壁内血肿所致。置入药物洗脱支架以缓解受压并支持冠状动脉的夹层。