急性 A 型主动脉夹层的罕见表现：右冠状动脉近端内膜袖状断裂和外翻，但无心肌缺血。

IF 1.5 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Journal of Cardiothoracic Surgery Pub Date : 2024-09-20 DOI:10.1186/s13019-024-03040-y

Ling-Chen Huang, Zeng-Bin Feng, Hong-Wei Guo

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引用次数: 0

摘要

背景：A 型主动脉夹层（TAAD）累及冠状动脉的情况非常罕见，但可能致命。手术中适当的心肌保护至关重要：在此，我们描述了一名因突发胸痛而就诊的 52 岁女性。CT 血管造影显示 TAAD 右冠状动脉受累。手术过程中，发现右冠状动脉近端内膜完全断裂并外翻。传统的心肌灌注方法效果不佳。手术中使用了获得专利的冠状动脉口灌注头，取得了良好的手术效果。患者出院时未出现并发症：本病例强调了术前仔细评估 TAAD 患者冠状动脉受累情况的必要性。这里使用的心肌保护方法非常有用，可以有效地应用于外科医生遇到的类似病例。

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Uncommon presentation of acute type A aortic dissection: sleeve-severed and everted proximal right coronary artery intima without myocardial ischaemia.

Background: Type A aortic dissection (TAAD) with coronary involvement is rare but potentially fatal. Proper myocardial protection during surgery is essential.

Case presentation: Here, we describe a 52-year-old woman who presented with sudden chest pain. CT angiography revealed TAAD with right coronary artery involvement. During surgery, the proximal intima of the right coronary artery was found to be completely severed and everted. Conventional myocardial perfusion methods were inadequate. A patented perfusion tip for coronary artery orifice perfusion was used, resulting in favourable surgical outcomes. The patient was discharged without complications.

Conclusions: This case emphasizes the need for careful preoperative assessment of coronary involvement in TAAD patients. The myocardial protection method used here is very helpful and can be applied effectively in similar cases encountered by surgeons.

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来源期刊

Journal of Cardiothoracic Surgery 医学-心血管系统

CiteScore

2.50

自引率

6.20%

发文量

286

审稿时长

4-8 weeks

期刊介绍： Journal of Cardiothoracic Surgery is an open access journal that encompasses all aspects of research in the field of Cardiology, and Cardiothoracic and Vascular Surgery. The journal publishes original scientific research documenting clinical and experimental advances in cardiac, vascular and thoracic surgery, and related fields. Topics of interest include surgical techniques, survival rates, surgical complications and their outcomes; along with basic sciences, pediatric conditions, transplantations and clinical trials. Journal of Cardiothoracic Surgery is of interest to cardiothoracic and vascular surgeons, cardiothoracic anaesthesiologists, cardiologists, chest physicians, and allied health professionals.