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医源性主动脉冠状动脉夹层导致的严重右心室梗死经手术修复和体外膜肺氧合成功治疗。

Severe right ventricular infarction due to iatrogenic aortocoronary dissection successfully treated by surgical repair and extracorporeal membrane oxygenation.

作者信息

Ono Shunya, Kawamoto Shuhei, Fukushima Toshiya, Shimozawa Motoharu, Tateishi Retsu, Haba Fumiya, Nakahara Yoshinori, Kanemura Takeyuki

机构信息

Department of Cardiovascular Surgery, IMS Katsushika Heart Center, 3-30-1 Horikiri, Katsushika, Tokyo 124-0006, Japan.

出版信息

J Surg Case Rep. 2024 Jan 3;2024(1):rjad711. doi: 10.1093/jscr/rjad711. eCollection 2024 Jan.

Abstract

Iatrogenic aortocoronary dissection (IACD) is a rare but potentially fatal complication of percutaneous coronary intervention or coronary angiography (CAG). In particular, if the condition of the patient is complicated by cardiogenic shock and right ventricular (RV) dysfunction, the mortality rate is high. Herein, we report the case of an 85-year-old woman with IACD who underwent elective CAG of the right coronary artery complicated with cardiogenic shock due to RV infarction. After prompt surgical repair and postoperative extracorporeal membrane oxygenation, the postoperative course was uneventful and the patient was discharged to a rehabilitation facility.

摘要

医源性主动脉冠状动脉夹层(IACD)是经皮冠状动脉介入治疗或冠状动脉造影(CAG)罕见但可能致命的并发症。特别是,如果患者病情合并心源性休克和右心室(RV)功能障碍,死亡率很高。在此,我们报告一例85岁患有IACD的女性患者,其接受了右冠状动脉择期CAG,并发因右心室梗死导致的心源性休克。经过及时的手术修复和术后体外膜肺氧合,术后过程顺利,患者出院前往康复机构。

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