在手术上更换大动脉门后的复发性STEMI
Shanjot Brar1, Suleman Aktaa2, Krishnan Ramanathan1
1Department of Cardiology, St Paul's Hospital, Vancouver, British Columbia, Canada.
JACC. Case reports
|October 23, 2025
概括
使用COR-KNOT suturing进行的大动脉置换的罕见并发症导致ST段升高心肌梗塞,这是由于右冠状动脉骨干的干扰. 多模式成像诊断了这个问题,导致成功的穿皮冠状动脉干预.
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
- 心脏成像 - - 心脏成像
背景情况:
- 一名63岁的男性进行了大动脉门替换,用On-X门进行了切换.
- 使用COR-KNOT接,以促进最少侵入性的迷你胸切除方法.
研究的目的:
- 报告一个ST段升高心肌梗塞 (STEMI) 的独特病例.
- 为了突出COR-KNOT干扰冠状动脉骨的潜在并发症.
主要方法:
- 患者经历了反复复发的STEMI尽管抗凝药.
- 冠状动脉扫描和血管内超声检查显示,右冠状动脉 (RCA) 骨架上存在填充缺陷.
- 心脏计算机断层扫描证实了COR-KNOT与RCA的干扰.
主要成果:
- 在RCA ostium的皮肤冠状动脉干预 (PCI) 成功进行.
- 患者在PCI后经历了积极的结果.
结论:
- 这是第一个由自动器干扰引起的STEMI病例.
- 迷你胸椎切除术和COR-KNOT的结合可能会导致这种罕见的并发症.
- 多模式成像对于诊断这种不寻常的病例至关重要;COR-KNOT可以阻碍冠状动脉流动,导致暂时性阻塞.
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