Kishi Yoshikuni, Yoshida Hideo, Mohri Tohru, Inoue Tomoya, Hisamochi Kunikazu
Department of Cardiovascular Surgery, Okayama University, Okayama, Japan.
Kyobu Geka. 2023 May;76(5):404-407.
A 72-year-old female had persistent severe chest pain while climbing stairs. She was diagnosed as having acute coronary syndrome, and underwent an emergency coronary angiography (CAG). The right coronary artery (RCA) ostium was sub-totally occluded. Echocardiography revealed a 10 mm mobile mass at the right coronary cusp of the aortic valve. To avoid total obustruction on two drug eluting stents were placed at the RCA ostium so as to have the proximal end protrude into the right Valsalva sinus. Thus, her hemodynamic condition was stabilized. The tumor was surgically resected and the stents were easily removed. Pathologically, the tumor was papillary fibroelastoma. Postoperative aortic regurgitation was minimal echocardiography, and CAG showed normal RCA.
一名72岁女性在爬楼梯时持续出现严重胸痛。她被诊断为急性冠状动脉综合征,并接受了急诊冠状动脉造影(CAG)。右冠状动脉(RCA)开口处几乎完全闭塞。超声心动图显示主动脉瓣右冠状动脉瓣叶处有一个10毫米的活动肿物。为避免完全阻塞,在右冠状动脉开口处放置了两个药物洗脱支架,使近端伸入右瓦尔萨尔瓦窦。因此,她的血流动力学状况得以稳定。肿瘤通过手术切除,支架很容易取出。病理检查显示肿瘤为乳头状纤维弹性瘤。术后超声心动图显示主动脉反流极轻微,冠状动脉造影显示右冠状动脉正常。