马凡综合征患者行半Cabrol手术并使用覆膜支架进行高危左主干血管成形术
High-Risk Left Main Angioplasty With Covered Stent in Marfan Patient With Hemi-Cabrol Surgery.
作者信息
Jallad Pedro Sergio Soares, Marins Pedro Henrique Almeida, Suárez Luis Rafael, Steffen Samuel Padovani, de Souza Thomé Hugo Oliveira, Scoppetta Luiz Raphael Donoso, Campos Carlos M, de Brito Fabio Sandoli, Abizaid Alexandre, Ribeiro Henrique B
机构信息
Cardiology Department, Heart Institute of University of São Paulo, São Paulo, Brazil.
Cardiothoracic Surgical Department, Heart Institute of University of São Paulo, São Paulo, Brazil.
出版信息
JACC Case Rep. 2025 Jun 18;30(15):103694. doi: 10.1016/j.jaccas.2025.103694.
INTRODUCTION
The Cabrol procedure is a complex surgical technique with potential complications, including graft stenosis. We report a successful percutaneous coronary intervention using a peripheral covered stent to treat Cabrol graft stenosis.
CASE PRESENTATION
A 49-year-old male with Marfan syndrome and prior aortic surgery, including a hemi-Cabrol graft to the left main artery, presented with angina and dyspnea. Imaging revealed severe stenoses in the Cabrol-left main artery anastomosis and right coronary artery ostium. Percutaneous coronary intervention (PCI) was performed for the right coronary artery with a drug-eluting stent, followed by PCI for the Cabrol graft using a 7- × 26-mm covered stent via brachial access.
OUTCOMES
The procedure was successful, with no complications. At 2-year follow-up, the patient remains asymptomatic, with preserved function and no restenosis.
CONCLUSION
PCI with a peripheral covered stent is a feasible, less-invasive alternative to surgery for Cabrol graft stenosis, offering favorable outcomes in high-risk patients.
引言
卡布罗尔手术是一种复杂的外科技术，存在包括移植物狭窄在内的潜在并发症。我们报告了一例使用外周覆膜支架成功进行经皮冠状动脉介入治疗卡布罗尔移植物狭窄的病例。
病例介绍
一名49岁患有马凡综合征且曾接受主动脉手术（包括左主干动脉半卡布罗尔移植物）的男性，出现心绞痛和呼吸困难。影像学检查显示卡布罗尔-左主干动脉吻合口及右冠状动脉开口严重狭窄。对右冠状动脉进行了药物洗脱支架的经皮冠状动脉介入治疗（PCI），随后通过肱动脉途径使用7×26毫米覆膜支架对卡布罗尔移植物进行PCI。
结果
手术成功，无并发症。在2年的随访中，患者无症状，功能保留且无再狭窄。
结论
外周覆膜支架PCI是卡布罗尔移植物狭窄手术的一种可行、侵入性较小的替代方法，在高危患者中可提供良好的结果。
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