Tseng C D, Chen C Y, Chiang F T, Hsu K L, Lo H M, Tseng Y Z, Tsai C H
Department of Internal Medicine, National Taiwan University Hospital, Taipei, ROC.
J Formos Med Assoc. 1996 Oct;95(10):789-92.
A 62-year-old woman who had coronary artery disease and hypertrophic cardiomyopathy received percutaneous transluminal coronary angioplasty and endomyocardial biopsy. She withstood the procedure well. However, delayed pericardial tamponade occurred 2 hours after discharge from the cardiac catheterization laboratory. Despite pericardial drainage with a pigtail catheter and blood transfusion, the patient required emergency surgery. An oozing diagonal branch of the left anterior descending coronary artery was found. Ligation of this small branch stabilized the hemodynamics. Avoidance of improper positioning of the guide wire in the small coronary artery branch is important in preventing arterial wall trauma and subsequent perforation.
一名患有冠状动脉疾病和肥厚型心肌病的62岁女性接受了经皮腔内冠状动脉成形术和心内膜活检。她手术过程耐受良好。然而，在从心导管实验室出院2小时后发生了迟发性心包填塞。尽管。尽管使用猪尾导管进行了心包引流并输血，但患者仍需要紧急手术。发现左前降支冠状动脉有一个渗血的对角支。结扎这个小分支稳定了血流动力学。避免导丝在小冠状动脉分支中不当定位对于预防动脉壁创伤和随后的穿孔很重要。
