Roithinger F X, Berent R, Punzengruber C, Maurer E, Ng C K, Hartl P, Pachinger O
II. Interne Abteilung/Kardiologie, Allgemeines Krankenhaus der Barmherzigen Schwestern vom Hl. Kreuz, Wels.
Wien Klin Wochenschr. 1996;108(17):552-4.
The development of left main coronary artery stenosis is a rare complication arising after aortic valve replacement. We report the different clinical course of two cases. One patient developed typical exertional angina 3 months after uneventful aortica valve replacement. Coronary stenosis had been excluded on preoperative coronary angiography. One day before hospital admission for coronary angiography the patient died suddenly. The second patient reported symptoms typical of angina 6 months after aortic valve replacement. Coronary angiography revealed critical left coronary ostial stenosis, which was successfully treated by surgical revascularization. These cases demonstrate the rare, yet potentially fatal complication of left coronary ostial stenosis. Early coronary angiography seems warranted in the event of typical exertional angina, even after angiographic exclusion of relevant coronary artery stenosis before aortic valve replacement.
左冠状动脉主干狭窄是主动脉瓣置换术后罕见的并发症。我们报告两例不同的临床病程。一例患者在主动脉瓣置换术顺利完成3个月后出现典型劳力性心绞痛。术前冠状动脉造影已排除冠状动脉狭窄。在因冠状动脉造影住院前一天，患者突然死亡。第二例患者在主动脉瓣置换术后6个月出现典型心绞痛症状。冠状动脉造影显示左冠状动脉开口严重狭窄，通过外科血运重建成功治疗。这些病例表明左冠状动脉开口狭窄这种罕见但可能致命的并发症。即使在主动脉瓣置换术前血管造影已排除相关冠状动脉狭窄，出现典型劳力性心绞痛时早期进行冠状动脉造影似乎是必要的。
