经皮冠状动脉介入治疗冠状窦前降支分叉区的策略优化

Y. Shevchenko, D. Ermakov, Vakhrameeva A.Y
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摘要

引言:本研究的目的是评估冠状窦心电图(ECG-CS)方法在优化冠状动脉(CA)支架分叉病变(BL)中的可能性。材料与方法:43例稳定型冠心病伴假性前降动脉BL患者纳入本研究。在经皮冠状动脉介入治疗(PCI)开始时,我们在他们的冠状窦内放置了一个10管电极。使用WorkMate电生理记录系统进行缺血指导。结果:43例CHD患者中,11例(25%)的ADA支架置入术后心内导联(CS3-4)的对角支(DB)重建及缺血动力学(p<0.05)均符合心电图(ECG-CS)。9名患者(20.9%)成功地进行了临时性T形支架植入,而其他2名患者需要第二次支架植入。结论:ECG-CS为优化CA分叉区的冠状动脉介入治疗提供了可能。
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Tactics Optimization of Percutaneous Coronary Intervention in the Area of Bifurcation of the Anterior Descending Artery by Means of Cardiography from the Coronary Sinus
Introduction: The aim of this investigation is to evaluate the possibilities of the method of cardiography from the coronary sinus (ECG-CS) in optimization of stenting bifurcation lesions (BL) of coronary arteries (CA). Materials and Methods: 43 patients with stable CHD with pseudo-BL of the anterior descending artery (ADA) were included in this investigation. We placed a 10-canal electrode into their coronary sinus at the beginning of percutaneous coronary intervention (PCI). Ischemic guidance was done with the WorkMate electrophysiological recording system. Results: In 11 patients (25%) out of 43 with CHD, the diagonal branch (DB) comprometation and ischemia dynamics (p<0.05) in intracardiac lead (CS 3-4) after ADA stenting were discovered according to ECG-CS. Nine patients (20.9%) underwent successful provisional-T-stenting, while a second stent was required for the other 2 patients. Conclusion: ECG-CS provides the possibility to optimize coronary intervention in the area of CA bifurcation.
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