冠状动脉肌桥动脉上肌切开术后的成功病程及左前降支的挤奶效应

Successful course after supraarterial myotomy for myocardial bridging and milking effect of the left anterior descending artery.

作者信息

Grondin P, Bourassa M G, Noble J, Petitclerc R, Dydra I

出版信息

Ann Thorac Surg. 1977 Nov;24(5):422-9. doi: 10.1016/s0003-4975(10)63435-2.

Abstract

We report 3 patients having a grade II milking effect of the proximal left anterior descending artery (LAD) and suffering from angina. Preoperative myocardial ischemia was demonstrated by stress ECG in all 3 and by pacing and lactates studies in 2. Surgical decompression of the systolically constricted artery has resulted in disappearance of angina, milking, and ischemia. Severe milking of the LAD is a rare entity, probably congenital in origin, capable of producing myocardial ischemia and possibly causing sudden death. More studies regarding its etiology and pathophysiology are necessary. Biopsy of the myocardium surrounding the artery could be useful.

摘要

我们报告了3例左前降支（LAD）近端出现II级挤奶效应并患有心绞痛的患者。所有3例患者术前通过负荷心电图证实有心肌缺血，2例通过起搏和乳酸研究证实有心肌缺血。对收缩期狭窄动脉进行手术减压后，心绞痛、挤奶效应和缺血均消失。LAD严重挤奶效应是一种罕见的情况，可能起源于先天性，能够导致心肌缺血并可能引起猝死。有必要对其病因和病理生理学进行更多研究。对动脉周围心肌进行活检可能会有帮助。