当灾难的3个基本面在选择性PCI期间相遇时
Max Wagener1, Jasper Boeddinghaus1, Gregor Leibundgut1
1University Heart Center Basel, University Hospital Basel, Basel, Switzerland.
JACC. Case reports
|February 18, 2025
概括
本案例研究详细介绍了一个易受伤害的患者经历了多次穿皮冠状动脉干预 (PCI) 的并发症,包括血管破裂和支架脱. 尽管进行了先进的干预,但患者因心脏性休克而死亡.
科学领域:
- 干预心脏病学 干预心脏病学
- 心血管医学 心血管医学
- 患者安全 患者安全
背景情况:
- 灾害风险是危险,脆弱性和能力的函数.
- 穿皮冠状动脉干预 (PCI) 是一种用于缺血性心脏病的常见程序.
- 复杂的PCI案例可能会带来重大风险和挑战.
研究的目的:
- 报告一个罕见的病例,多个PCI相关的并发症,在一个脆弱的病人.
- 为了说明PCI期间严重的阴性冠状动脉损伤的管理策略.
- 突出患者脆弱性和过程性风险在不良结果中的相互作用.
主要方法:
- 一名患有症状性缺血性心脏病的脆弱患者接受了选择性PCI.
- 一系列的五个不同的PCI相关并发症顺序发生.
- 治疗包括立即气球封闭,远端卷圈,支架植入,支架提取和支架移植粉碎.
主要成果:
- 并发症包括远端冠状动脉穿孔,电风暴,没有再流,血管破裂和支架脱.
- 通过使用定制的陷成功地恢复了脱落的支架.
- 尽管进行了广泛的干预努力,但患者经历了长时间的复苏.
- 这位患者最终因心脏性休克而死亡.
结论:
- 这一案例凸显了PCI过程中灾难性的,多方面的并发症的可能性,即使在选择性设置中也是如此.
- 这种严重的阴性损伤的管理需要使用先进的干预技术.
- 患者的脆弱性和能力有限显著影响结果,即使在最佳的程序管理.
相关概念视频
Cardiac Catheterization I: Pre-Procedure Overview
3.4K
Cardiac catheterization is an invasive diagnostic technique used to identify and evaluate structural and functional diseases of the heart and major blood vessels. This technique diagnoses congenital heart disease, coronary artery disease, valvular heart disease, and coronary spasms and assesses ventricular function. It helps guide treatment decisions, including the need for revascularization procedures like percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) and...
3.4K
Acute Coronary Syndrome I: Introduction
2.1K
Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
2.1K
Acute Coronary Syndrome IV: Interprofessional Care
525
IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
525
Introduction Cardiac Emergencies
569
Cardiac emergencies are critical situations involving the heart that require immediate medical intervention to prevent severe complications or death. These emergencies often arise from underlying heart conditions that impair the heart's ability to function correctly.Types of Cardiac EmergenciesThe most common types of cardiac emergencies include Acute Coronary Syndrome (ACS), myocardial infarction (MI), cardiac arrest, and heart failure.Acute Coronary Syndrome (ACS)Acute Coronary Syndrome (ACS)...
569
Cardiomyopathy III: Hypertrophic Cardiomyopathy
810
Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...
810
Cardiomyopathy V: Interprofessional Care
761
Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
761


