在冠状动脉解剖后形成的左心室动脉瘤发生血栓的外科治疗
Olena K Gogayeva1, Oleksandr O Nudchenko2, Mykola L Rudenko1
1Department of Surgical Treatment of Ischemic Heart Disease, National Amosov Institute of Cardiovascular Surgery of the National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine.
American heart journal plus : cardiology research and practice
|November 10, 2025
概括
自发冠状动脉解剖 (SCAD) 可以导致左心室动脉瘤 (LVA) 和血栓. 这一案例显示了SCAD后血栓化LVA的成功手术治疗,尽管有复发性血栓和栓塞.
科学领域:
- 心脏病学 心脏病学
- 血管外科 血管外科
背景情况:
- 自发冠状动脉解剖 (SCAD) 是急性心肌梗塞 (MI) 的原因之一.
- 延迟治疗SCAD可能导致危及生命的并发症,如左心室动脉瘤 (LVA) 与血栓形成和栓塞.
研究的目的:
- 报告一个成功手术治疗SCAD二次性血栓化LVA的病例.
- 突出重复性血栓塞和栓塞在这种情况下的挑战.
主要方法:
- 一名患有SCAD的42岁男性患上了带有血栓的LVA.
- 诊断工作包括心电图,心声学和冠状动脉血管学.
- 手术干预包括冠状动脉旁路移植 (CABG),LVA切除和血栓切除在上.
- 治疗复发性血栓形成和下肢动脉栓塞需要重新手术.
主要成果:
- 血栓化LVA的初始手术成功,患者在术后第8天出院.
- 左心室顶部和下肢动脉的复发性血栓塞发生在手术后15个月.
- 重置心脏手术成功进行,患者在术后第6天出院.
结论:
- 由于SCAD导致的血栓化LVA,手术治疗可能是有效的.
- 无法控制的抗凝治疗可能会导致复发性血栓形成和全身栓塞.
- 重新进行心脏手术是治疗复发性并发症的可行选择.
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