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冠狀動脈介入治療引發升主動脈剝離:病例報告及文獻回顧

Concurrent Dissections of the Ascending Aorta and Right Coronary Artery during Percutaneous Coronary Intervention: A Case Report

摘要


冠狀動脈介入治療引發主動脈剝離是一種罕見但可能致命的併發症。熟悉此併發症,並能及早發現和給予適當的處理是非常重要的。我們報告一名78歲的女性,因急性心肌梗塞接受心導管及介入性治療。當我們試著打通阻塞的右冠狀動脈時,併發右冠狀動脈開口處剝離,並往後延伸至升主動脈。文獻回顧發現此狀況通常需要外科手術治療,或者冠狀動脈開口處支架植入。然而,此病人接受內科保守治療後,經一系列的非侵入性影像學檢查,證實升主動脈剝離已癒合。

並列摘要


Iatrogenic aortic dissection caused by coronary angiography or angioplasty is a rare but potentially life-threatening complication. Awareness of the complication and its prompt recognition are important. We describe a 78-year-old woman who underwent coronary angioplasty for acute non-ST elevation myocardial infarction. An ostial dissection of the right coronary artery (RCA) with extension into the entire ascending aorta occurred during the an attempt to recanalize an occluded RCA. The literature recommends surgical intervention or stenting of the coronary dissection under these circumstances. However, the patient was managed conservatively. Serial evaluation with noninvasive imaging studies showed resolution of the ascending aortic dissection.

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