通过左心房附属体剪贴管理左主干压缩的策略:一个案例报告
Atsuyuki Mitsuishi1, Keisuke Yoshida1, Yujiro Miura1
1Department of Cardiovascular Surgery, Kochi Medical School Hospital, 185-1, Kohasu, Okohcho, Nankoku-shi 783-8505, Kochi Prefecture, Japan.
European heart journal. Case reports
|December 13, 2023
概括
左心房附属体 (LAA) 关闭可降低中风风险,但可能导致冠状动脉压缩. 仔细的剪贴选择和放置对于防止左主干 (LMT) 狭窄至关重要.
科学领域:
- 心血管外科心血管外科
- 干预心脏病学 干预心脏病学
- 医疗器械技术 医疗器械技术
背景情况:
- 左心房附属体 (LAA) 关闭越来越多地用于减少心房动患者中风风险.
- 冠状动脉压缩是LAA闭塞装置的潜在,危及生命的并发症.
- 在LAA附近的解剖学变异可能会增加与设备有关的并发症的风险.
研究的目的:
- 报告LAA剪贴关闭后的左主干 (LMT) 狭窄病例.
- 讨论LAA关闭后LMT压缩的管理策略.
- 强调在LAA关闭程序中解剖评估和设备选择的重要性.
主要方法:
- 一名75岁的男性接受了大动脉动脉瘤修复,心房移除和LAA用剪贴关闭.
- 手术后,患者出现低血压,并通过冠状动脉血管学发现LMT狭窄.
- 进行皮肤冠状动脉干预 (PCI) 来解决LMT狭窄症.
主要成果:
- LAA剪贴的关闭与LMT起源的急性90%狭窄有关.
- 成功的PCI恢复了冠状动脉的血液流动,稳定了血液动力学.
- 在压缩中,LAA ostium和LMT之间的解剖关系与压缩有关.
结论:
- 关闭LAA剪贴需要仔细考虑LAA ostium与LMT的距离.
- 在高风险的解剖情况中,可能需要使用替代的LAA闭合方法或技术修改.
- 在LAA关闭程序后,对冠状动脉压缩的警和及时干预至关重要.
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