双阳性患者的复杂左主分支PCI:一种独特的干预方法 - 一个病例报告
H S Natraj Setty1, Rahul Patil1, Chethan Kumar1
1Cardiology Department, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore, Karnataka, India.
International journal of surgery case reports
|March 19, 2025
概括
在艾滋病毒 (PLWH) 和COVID-19患者中治疗急性冠状动脉综合征 (ACS) 需要团队合作. 穿皮冠状动脉干预 (PCI) 是一种可行且有效的策略,用于血液动力不稳定的PLWH的紧急再血管化.
科学领域:
- 心脏病学 心脏病学
- 传染性疾病 传染性疾病
- 干预心脏病学 干预心脏病学
背景情况:
- 艾滋病毒感染者 (PLWH) 患心血管疾病的风险较高,COVID-19进一步加剧了这种情况.
- 由于慢性炎症和潜在的药物相互作用,PLWH中的急性冠状动脉综合征 (ACS) 管理具有挑战性.
研究的目的:
- 在HIV阳性,COVID-19阳性患者中,为复发性ACS提出紧急皮肤通冠状动脉干预 (PCI) 的病例.
- 突出在这种复杂的患者群体中管理ACS的挑战和考虑因素.
- 评估PCI在血液动力学不稳定的PLWH与并发COVID-19中的可行性和有效性.
主要方法:
- 一名41岁的HIV和COVID-19感染的男性呈现ST段升高ACS和血液动力学不稳定.
- 冠状动脉扫描显示出显著的狭窄,SYNTAX评分I为12.
- 一个多学科的心脏团队推PCI超过CABG,患者经历了成功的双吻粉碎 (DK粉碎) 分叉支架.
主要成果:
- 患者在PCI后实现了TIMI III流动和症状缓解.
- 与PCI相比,SYNTAX评分II预测CABG的死亡风险较高 (5.8%与15.3%相比).
- 在复杂的分叉病变中,DK粉碎技术表现出了有利的结果.
结论:
- 在COVID-19的PLWH中管理ACS需要采用多学科的方法.
- PCI是一种可行且有效的策略,用于在血液动力学不稳定的PLWH中紧急冠状动脉再血管化.
- 在获得进一步随机试验数据之前,PCI仍然是PLWH紧急重血管化的首选策略.
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