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病例报告：起源于右冠状动脉窦的动脉间左冠状动脉导致复发性心源性休克，经机械循环支持成功救治。

Case Report: Recurrent cardiogenic shock caused by inter-arterial left coronary artery originating from the right coronary sinus, successfully rescued by mechanical circulatory support.

作者信息

Jin Tietuo, Wang Rui, Dong Liang, Lv Yvhang

机构信息

Department of Intensive Care Medicine, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, Zhejiang, China.

Department of Dermatology, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, Zhejiang, China.

出版信息

Front Cardiovasc Med. 2025 Jan 3;11:1466524. doi: 10.3389/fcvm.2024.1466524. eCollection 2024.

DOI:10.3389/fcvm.2024.1466524
PMID:39830007
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11739284/
Abstract

A young female patient suffered cardiogenic shock after undergoing surgery for an ectopic pregnancy. Coronary artery computed tomography angiography (CTA) revealed a left main artery (LM) originating from the right coronary sinus and traveling between the aorta and pulmonary artery. We successfully resuscitated the patient with mechanical circulatory support using veno-arterial extracorporeal membrane oxygenation (VA-ECMO) and an intra-aortic balloon pump (IABP). The patient subsequently underwent surgery thereafter. When sudden cardiogenic shock occurs in a young patient, it is important to be vigilant for anomalous aortic origin of a coronary artery (AAOCA).

摘要

一名年轻女性患者在异位妊娠手术后发生心源性休克。冠状动脉计算机断层扫描血管造影（CTA）显示左主干动脉（LM）起源于右冠状动脉窦，并走行于主动脉和肺动脉之间。我们使用静脉-动脉体外膜肺氧合（VA-ECMO）和主动脉内球囊泵（IABP）通过机械循环支持成功复苏了该患者。患者随后接受了手术。当年轻患者突然发生心源性休克时，警惕冠状动脉异常起源于主动脉（AAOCA）很重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f6b7/11739284/2beb946f3fc8/fcvm-11-1466524-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f6b7/11739284/b99b66d5c069/fcvm-11-1466524-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f6b7/11739284/759754a8a684/fcvm-11-1466524-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f6b7/11739284/e058c76e8deb/fcvm-11-1466524-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f6b7/11739284/2beb946f3fc8/fcvm-11-1466524-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f6b7/11739284/b99b66d5c069/fcvm-11-1466524-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f6b7/11739284/759754a8a684/fcvm-11-1466524-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f6b7/11739284/e058c76e8deb/fcvm-11-1466524-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f6b7/11739284/2beb946f3fc8/fcvm-11-1466524-g004.jpg

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本文引用的文献

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J Am Coll Cardiol. 2023 Nov 21;82(21):2034-2053. doi: 10.1016/j.jacc.2023.08.012. Epub 2023 Oct 16.
2
Clinical Presentation and Medium-Term Outcomes of Children With Anomalous Aortic Origin of the Left Coronary Artery: High-Risk Features Beyond Interarterial Course.儿童左冠状动脉异常起源于主动脉的临床表现和中期结果：动脉间型以外的高危特征。
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Case Report: Extracorporeal Membrane Oxygenation Followed by Intra-Aortic Balloon Counterpulsation Successfully Treated Cardiac Arrest Caused by Anomalous Origin of a Left Coronary Artery From the Right Coronary Sinus.
病例报告：体外膜肺氧合联合主动脉内球囊反搏成功治疗右冠状动脉窦左冠状动脉异常起源所致心脏骤停
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4
Wolf in Sheep's Clothing - The False Sense of Security in Patients With Anomalous Aortic Origin of a Coronary Artery Undergoing Submaximal Stress Testing.披着羊皮的狼——接受次极量负荷试验的冠状动脉异常起源于主动脉患者的虚假安全感
J Invasive Cardiol. 2021 May;33(5):E396-E397. doi: 10.25270/jic/21.00026.
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Risk stratification and surgery for anomalous aortic origin of a coronary artery: Onward through the fog.
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