Loire R, Tabib A
Arch Mal Coeur Vaiss. 1985 Jun;78(6):821-7.
We reviewed 61 autopsy cases of coronary embolism observed over an 18 year period (up to the end of 1983) out of a total of 4 860 post-mortems performed on adults dying of cardiovascular causes in order to determine the nature and site of embolisation, the site of origin and establish the clinical features and evolution. A total of 75 emboli were found in the 61 cases (47 single, 11 double and 3 triple emboli). The emboli were recent fibrinothrombi in 43 cases; there were 9 associated calcific emboli, 2 embolized fragments of myocardium, 1 of Teflon and 1 of malignant tissue; the diagnosis was made "retrospectively" in 5 cases on a number of criteria. The main site of embolisation was the left anterior descending artery (34 cases) followed by the right coronary (20 cases), left circumflex (14 cases) and left main coronary artery (7 cases); obstruction was observed at the coronary ostium (7 left, 2 right) in 9 patients. The origins of the emboli were varied: 19 intracardiac thromboses (left atrial 10, left ventricule 6, suture of left atriotomy 3) 12 bacterial vegetations in cases of infective endocarditis, 10 thrombosis of prosthetic valves, 9 calcific emboli (8 aortic stenosis, 1 calcification of the ascending aorta) and 10 others.(ABSTRACT TRUNCATED AT 250 WORDS)
我们回顾了在18年期间（至1983年底）观察到的61例冠状动脉栓塞尸检病例，这些病例来自于对死于心血管疾病的成年人进行的总共4860例尸检，目的是确定栓塞的性质和部位、栓子的起源部位，并确定临床特征和病情发展。在61例病例中总共发现了75个栓子（47个单个栓子、11个双栓子和3个三栓子）。43例中的栓子为新鲜纤维蛋白血栓；有9个合并钙化栓子、2个心肌栓塞碎片、1个聚四氟乙烯栓子和1个恶性组织栓子；5例根据若干标准“回顾性”做出诊断。栓塞的主要部位是左前降支动脉（34例），其次是右冠状动脉（20例）、左旋支动脉（14例）和左冠状动脉主干（7例）；9例患者在冠状动脉开口处（7例在左冠状动脉开口，2例在右冠状动脉开口）观察到阻塞。栓子的来源各不相同：19个心内血栓形成（10个左心房血栓、6个左心室血栓、3个左心房切开术缝线处血栓），12个感染性心内膜炎病例中的细菌性赘生物，10个人工瓣膜血栓形成，9个钙化栓子（8个主动脉瓣狭窄、1个升主动脉钙化）和其他10个。（摘要截断于250字）
