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解锁有前景的治疗方法:心肌桥合并药物难治性心绞痛患者的药物洗脱支架。

Unlocking Promising Therapies: Drug-Eluting Stents in Medically Refractory Angina Patients With Myocardial Bridging.

机构信息

Department of Cardiology, Hacettepe University Faculty of Medicine, Ankara, Turkey.

Department of Cardiology, Ankara Etlik City Hospital, Ankara, Turkey.

出版信息

Am J Cardiol. 2023 Dec 1;208:72-74. doi: 10.1016/j.amjcard.2023.09.019. Epub 2023 Oct 9.

Abstract

Myocardial bridging (MB) is a congenital variation in which a coronary artery segment tunnels through the myocardium instead of following its usual epicardial route. Although MB is usually diagnosed incidentally and has a good long-term prognosis, it can lead to complications such as angina, myocardial infarction, arrhythmias, and sudden death. This study aimed to evaluate the outcomes of drug-eluting stent (DES) implantation in patients with MB and medically refractory angina. The study included 12 patients with significant MB who did not respond to maximal medical therapy and underwent DES implantation. The patients were followed up for a mean duration of 33 months. The procedural success rate was 92%, with only 1 patient experiencing acute coronary artery rupture during the procedure. During the follow-up period, none of the patients reported angina symptoms, required additional percutaneous coronary intervention, or developed stent thrombosis. One patient (8.3%) died from a non-cardiac cause. The procedure demonstrates a high procedural success rate and leads to favorable long-term outcomes, including the absence of angina symptoms and the avoidance of stent-related complications. In conclusion, this study suggests that DES implantation can serve as an effective treatment option for selected patients with medically refractory angina and significant MB.

摘要

心肌桥(MB)是一种先天性变异,其中冠状动脉段穿过心肌而不是遵循其通常的心外膜路径。尽管 MB 通常是偶然诊断的,并且具有良好的长期预后,但它可能导致并发症,如心绞痛、心肌梗死、心律失常和猝死。本研究旨在评估药物洗脱支架(DES)植入术在患有 MB 和药物难治性心绞痛的患者中的疗效。研究纳入了 12 名对最大药物治疗无反应且接受 DES 植入术的有明显 MB 的患者。患者平均随访 33 个月。手术成功率为 92%,仅 1 名患者在手术过程中发生急性冠状动脉破裂。在随访期间,没有患者报告心绞痛症状,需要额外的经皮冠状动脉介入治疗,也没有发生支架血栓形成。1 名患者(8.3%)因非心脏原因死亡。该手术显示出高的手术成功率,并带来了有利的长期结果,包括无心绞痛症状和避免支架相关并发症。总之,本研究表明,DES 植入术可作为药物难治性心绞痛和明显 MB 的有选择患者的有效治疗选择。

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