由于在导管切除过程中左环动脉损伤而导致的ST段升高心肌梗塞
Sahrai Saeed1, Erlend Eriksen2, Jian Chen2
1Department of Heart Disease, Haukeland University Hospital, Bergen, Norway; Department of Cardiology, Oslo University Hospital Ullevaal, Oslo, Norway; Faculty of Medicine, University of Oslo, Oslo, Norway.
JACC. Case reports
|August 8, 2025
概括
导管切除,虽然通常是安全的,但冠状动脉损伤的风险很低,特别是在冠状动脉鼻. 这一案例突出了一个罕见的热伤病病例,导致冠状动脉封闭,成功地用支架治疗.
科学领域:
- 心脏病学 心脏病学
- 干预性电生理学 干预性电生理学
背景情况:
- 导管切除是心律失常的常见治疗方法.
- 冠状动脉损伤是导管切除的罕见但严重的并发症.
- 风险因素包括接近冠状动脉和重复手术.
研究的目的:
- 报告冠状动脉封闭病例,这是冠状动脉鼻中导管切除的次要病例.
- 讨论热伤害的潜在机制.
- 为了突出成功的管理与药物释放支架.
主要方法:
- 一个53岁的女性患者的病例报告,患有复发性心房.
- 在冠状动脉鼻腔中重复导管切除.
- 通过冠状动脉血管学诊断冠状动脉封闭.
- 用药物释放支架进行治疗.
主要成果:
- 患者在切除后出现了胸部疼痛和ST段升高.
- 冠状动脉扫描显示了一个封闭的中环动脉.
- 据推测,这种闭塞是由于剥离过程中的直接热损伤造成的.
- 通过释放药物的支架,成功实现了重血管化.
结论:
- 除诱导的冠状动脉损伤,虽然很少见,但可以发生,特别是在冠状动脉鼻.
- 直接热伤害是这种并发症的一个合理机制.
- 及时诊断和干预支架可以带来有利的结果.
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