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穿皮冠状动脉干预后导致急性鼻节功能障碍的中心房结节动脉封闭:病例报告和系统审查

Pankaj Jariwala¹, Dilip Gude², Gururaj Pramod Kulkarni¹

¹Department of Cardiology, Yashoda Hospitals, Hyderabad, Telangana, India.

Pacing and clinical electrophysiology : PACE

|June 26, 2024

概括

穿皮冠状动脉干预 (PCI) 可以通过阻塞阴道心房结节动脉 (SANA) 引起鼻节功能障碍 (SND). 这可能导致严重的心脏问题,包括心脏性休克,需要仔细的术前评估.

科学领域:

心脏病学心脏病学
干预心脏病学干预心脏病学
电子生理学电子生理学

背景情况:

穿皮冠状动脉干预 (PCI) 的进步已经减少了分支封闭,但仍可能导致 sino-atrial结节动脉 (SANA) 封闭.
塞住SANA可以导致鼻节功能障碍 (SND),从无症状病例到需要起器的鼻停止.
在罕见的情况下,SND后PCI产生的结节逃生节奏可能表明心脏性休克.

研究的目的:

在LMCA-LCX分支后出现SND引起的心脏性休克病例PCI.
分析SANA缺血导致的PCI后SND的发生率和结果.
强调在PCI之前评估SANA领土的重要性.

主要方法:

一个病人的病例报告心脏发生性休克二次性到 SND 经过分叉 PCI.
对22项与SANA缺血相关的PCI后SND研究的综合文献综述.
对SANA阻塞病因,临床表现和管理结果的分析.

主要成果:

右冠状动脉 (RCA) 参与了96.1%的SND病例,而左环动脉 (LCX) 参与了3.9%.
在49.3%的病例中,SND无症状;在37.6%的症状病例中,发生了结节逃逸节奏.
28%需要临时起器,7.8%需要永久起器,5.2%接受了成功的SANA再通道.

结论:

由于PCI后的过渡性SANA缺血,急性SND可能会发生.
在植入支架之前,考虑SND风险至关重要.
对于最佳的PCI战略选择,在SANA地区进行彻底的斑块评估至关重要.

关键词:

左侧的主要冠状动脉.通过皮肤进行冠状动脉干预.中心心房结节动脉中心心室节点功能障碍

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