邢镇华,唐亮,方臻飞,沈向前,苏英杰,胡信群

• 1:中南大学湘雅二医院心内科

摘要(Abstract)：

<正>冠状动脉夹层是经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)常见的并发症之一,一般预后良好,但是逆行扩展至主动脉可造成冠状动脉-主动脉夹层(aortocoronary dissection,ACD)。ACD是一种罕见的严重PCI并发症,夹层的顺向或逆向延伸不仅可引起冠状动脉的急性闭塞致急性心肌梗死,而且可引起致命性的主动脉夹层、急性主动脉瓣反流、心脏压塞,甚至猝死。ACD病情危急,治疗难度较大,本文报道2例,现结合文献报告如下。1临床资料病例1女,59岁,因"胸前区疼痛5 d"入住外院心内

关键词(KeyWords)： 冠状动脉;夹层;经皮冠状动脉介入治疗;支架

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 邢镇华,唐亮,方臻飞,沈向前,苏英杰,胡信群

参考文献(References)：

• [1]Dunning DW,Kahn JK,Hawkins ET,et al.Iatrogenic coronary artery dissections extending into and involving the aortic root.Catheter Cardiovasc Interv,2000,51:387-393.
• [2]Shorrock D,Michael TT,Patel V,et al.Frequency and outcomes of aortocoronary dissection during percutaneous coronary intervention of chronic total occlusions;a case series and systematic review of the literature.Catheter Cardiovasc Interv,2014,84:670-675.
• [3]Carstensen S.Ward MR.Iatrogenic aortocoronary dissection;the case for immediate aortoostial stenting.Heart Lung Circ,2008,17;325-329.
• [4]Bae JH,Kim KB,Kim KS,et al.A case of aortocoronary dissection as a complication during a percutaneous transluminal coronary angioplasty(PTCA).Int J Cardiol,1998,66:237-240.
• [5]Lopez-Minguez JR,Climent V,Yen-Ho S,et al.Structural features of the sinus of valsalva and the proximal portion of the coronary arteries;their relevance to retrograde aortocoronary dissection.Rev Esp Cardiol,2006,59;696-702.
• [6]Perez-Castellano N,Garcia-Fernandez MA,Garcia EJ,et al.Dissection of the aortic sinus of Valsalva complicating coronary catheterization;cause,mechanism,evolution,and management.Cathet Cardiovasc Diagn,1998,43:273-279.
• [7]Spittell PC,Spittell JA Jr,Joyce JW,et al.Clinical features and differential diagnosis of aortic dissection;experience with 236cases(1980 through 1990).Mayo Clin Proc,1993,68;642-651.
• [8]Boukhris M,Tomasello SD,Marza F,et al.Iatrogenic aortic dissection complicating percutaneous coronary intervention for chronic total occlusion.Can J Cardiol,2015,31:320-327.
• [9]Santos M,Luz A,Silveira J,et al.Aortocoronary dissection complicating percutaneous angioplasty.Rev Port Cardiol,2011,30:745-747.
• [10]Park IW,Min PK,Cho DK,et al.Successful endovascular treatment of iatrogenic coronary artery dissection extending into the entire ascending aorta.Can J Cardiol,2008,24;857-859.
• [11]Wykrzykowska JJ,Carrozza J,Laham FU.Aortocoronary dissection with acute left main artery occlusion;successful treatment with emergent stenting.J Invasive Cardiol,2006,18;E217-E220.
• [12]Baumann S,Huseynov A,Behnes M,et al.Treatment optimization of aortocoronary dissection as a complication after heart catheterization using coronary computerized tomographic angiography.Can J Cardiol,2014,30;696.el3-5.