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[医源性左冠状动脉口狭窄。一例使用斯塔尔-爱德华兹主动脉瓣人工瓣膜的报告(作者译)]

[Iatrogenic ostial stenosis of the left coronary artery. Report of a case with Starr-Edwards aortic prosthesis (author's transl)].

作者信息

Betocchi S, Miceli D, Giudice P, Romano M, De Amicis V, Spampinato N, Giuffrida G

出版信息

G Ital Cardiol. 1979;9(11):1312-7.

PMID:553854
Abstract

A case of a 41 years-old-man, who had undergone surgical intervention ten years previously for aortic valve replacement in ECC with the coronary perfusion technique, is reported. This patient was studied because of the appearance of angina pectoris three months after the intervention and its progressive development. Selective left coronary angiography showed an ostial subocclusive stenosis; the run-off from the right coronary artery provided distal blood supply to the left coronary artery. A venous bypass was implanted between the aorta and the left anterior descending branch; the prosthesis was substituted because it was altered and caused hemolysis' problems. In accordance with most Authors late ostial coronary stenosis is a complication of the coronary perfusion technique, which is adopted for myocardial protection during surgical interventions for aortic valve replacement.

摘要

报道了一例41岁男性患者,该患者十年前在体外循环下采用冠状动脉灌注技术进行了主动脉瓣置换手术。该患者因术后三个月出现心绞痛并逐渐加重而接受研究。选择性左冠状动脉造影显示开口处亚闭塞性狭窄;右冠状动脉的血流为左冠状动脉提供了远端血供。在主动脉和左前降支之间植入了静脉旁路;由于人工瓣膜发生改变并导致溶血问题,对其进行了置换。根据大多数作者的观点,晚期开口处冠状动脉狭窄是冠状动脉灌注技术的一种并发症,该技术用于主动脉瓣置换手术期间的心肌保护。

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