经食管超声心动图诊断主动脉瓣置换术后冠状动脉开口狭窄

[Coronary ostial stenosis after an aortic valve replacement diagnosed by transesophageal echocardiography].

作者信息

Placer Peralta L J, Diarte de Miguel J A, Sánchez-Navarro F, Artal Burriel A, Monzón Lomas F J, San Pedro Feliu A

机构信息

Servicio de Cardiología, Hospital Miguel Servet, Zaragoza.

出版信息

Rev Esp Cardiol. 1993 Apr;46(4):255-6.

PMID:8469811

Abstract

We submit the case of a 75-year-old man that underwent aortic valve replacement whose preoperative coronary angiography showed lesion-free coronaries. Two months after surgery he began to feel rapidly progressing effort angina pectoris. Transesophageal echocardiography showed prosthetic normal function while allowing the study of the great coronary trunks. We observed the presence of a 50% stenosis at the ostium of the left coronary artery trunk due to the use of selective coronary cannulation to supply cardioplegia solution during valve replacement. A second coronary angiography confirmed this finding. Transesophageal echocardiography may be used as an initial diagnostic method when coronary ostial stenosis is suspected after aortic valve replacement.

摘要

我们报告一例75岁男性患者，该患者接受了主动脉瓣置换术，术前冠状动脉造影显示冠状动脉无病变。术后两个月，他开始感到进行性加重的劳力性心绞痛。经食管超声心动图显示人工瓣膜功能正常，同时可以对主要冠状动脉进行检查。我们观察到，由于在瓣膜置换期间使用选择性冠状动脉插管来供应心脏停搏液，导致左冠状动脉主干开口处出现50%的狭窄。第二次冠状动脉造影证实了这一发现。当怀疑主动脉瓣置换术后冠状动脉开口狭窄时，经食管超声心动图可用作初始诊断方法。