Chawla S K, Najafi H, Javid H, Serry C
Ann Thorac Surg. 1977 Feb;23(2):135-8. doi: 10.1016/s0003-4975(10)64086-6.
Four patients are reported with obstruction of the proximal left main coronary artery that developed following prosthetic replacement of the aortic valve. Angina pectoris and ventricular arrhythmias were the presenting clinical manifestations. Anterior descending coronary artery bypass was used in 3 of the patients and vein patch angioplasty in the fourth. One patient died in the hospital. The 3 survivors achieved reflief from angina and ventricular arrhythmias. One patient died from nephropathy 2 1/2 years later. Two patients remained asymptomatic 1 1/2 and 3 years later, respectively. This review emphasizes the need for prompt coronary angiography in patients experiencing angina pectoris after aortic valve replacement, and it shows that coronary revascularization can be performed with satisfactory results.
本文报告了4例在主动脉瓣人工置换术后发生左冠状动脉主干近端梗阻的患者。心绞痛和室性心律失常为主要临床表现。3例患者采用了前降支冠状动脉搭桥术，第4例采用了静脉补片血管成形术。1例患者在医院死亡。3例幸存者的心绞痛和室性心律失常症状得到缓解。1例患者在2年半后死于肾病。另外2例患者分别在1年半和3年后仍无症状。本综述强调了对主动脉瓣置换术后出现心绞痛的患者进行及时冠状动脉造影的必要性，并表明冠状动脉血运重建术可取得满意效果。
