经皮冠状动脉腔内成形术并发冠状动脉穿孔  

Coronary Arterial Perforation Complicated by Percutaneous Transluminal Coronary Angioplasty

作　　者：乔树宾[1] 高润霖[1] 陈纪林[1] 左鲁宁[2] 杨跃进[1] 秦学文[1] 姚民[1] 刘海波[1] 徐波[1] 吴永健[1] 姚康宝[1] 

机构地区：[1]北京市中国医学科学院中国协和医科大学心血管病研究所阜外心血管病医院冠心病研究室,100037 [2]山东省烟台市烟台山医院

出　　处：《中国循环杂志》2000年第3期141-142,共2页Chinese Circulation Journal

摘　　要：目的 :探讨经皮冠状动脉腔内成形术 (PTCA)并发冠状动脉穿孔的发生及其适当处理对策。　　方法 :对我院进行的所有 PTCA病例发生冠状动脉穿孔者进行回顾性分析。　　结果 :共行 PTCA治疗 172 8例 ,并发冠状动脉穿孔 6例 ,均为完全闭塞性病变 ,发生率为 0 .35 %。3例漏入心包 ,2例形成冠状动脉左心室瘘 ,1例形成冠状动脉右心室瘘。经球囊长时间加压扩张 ,穿孔全部闭合 ;无一例需要进行心包穿刺引流和急诊冠状动脉旁路移植术及死亡。　　结论 :PTCA并发冠状动脉穿孔并不常见 ,只要及时发现 ,恰当处理 ,可以避免严重并发症的发生。Objective:To approach the incidence and treatment of coronary arterial perforation. Methods:Patients treated by percutaneous transluminal coronary angioplasty(PTCA)were retrospectively analyzed. Results:Among 1 728 patients undergoing PTCA,6 cases were complicated by coronary arterial perforation,the incidence was 0 35%.The lesion for all 6 cases was total occlusion.A leakage of contrast medium into the pericardial space was observed in 3 cases,the formation of a fistula between the coronary artery and the ventricular cavity in 3 cases(left in 1 case and right in 2 cases).The perforation was occluded by long time balloon inflation in all 6 cases.No pericardiocentesis and emergency coronany artery bypass grafting (CABG) was needed and no death occured. Conclusion:Coronary arterial perforation complicated by PTCA was not common,rapid diagnosis and active treatment are very important in order to avoid severe complications.

关 键 词：血管成形术 经皮冠状动脉 冠心病 冠状动脉穿孔 

分 类 号：R541.4[医药卫生—心血管疾病]