经皮冠状动脉介入治疗急性非ST段抬高型心肌梗死合并主动脉瓣Lambl’s赘生物1例  

Percutaneous coronary intervention for the treatment of non-ST-segment elevation myocardial infarction combined with Lambl's excrescences on the aortic valve:a case report

作　　者：叶孟奇 杨帮国 张紫微 王奖 白洁 YE Meng-qi;YANG Bang-guo;ZHANG Zi-wei;WANG Jiang;BAI Jie(Department of Cardiology,Fuwai Yunnan Hospital,Chinese Academy of Medical Sciences,Affiliated Cardiovascular Hospital of Kunming Medical University,Kunming 650102,China;Department of Ultrasonography,Fuwai Yunnan Hospital,Chinese Academy of Medical Sciences,Affiliated Cardiovascular Hospital of Kunming Medical University,Kunming 650102,China)

机构地区：[1]云南省阜外心血管病医院昆明医科大学附属心血管病医院心内科,云南昆明650102 [2]云南省阜外心血管病医院昆明医科大学附属心血管病医院超声科,云南昆明650102

出　　处：《中国介入心脏病学杂志》2025年第3期176-180,共5页Chinese Journal of Interventional Cardiology

基　　金：急性心肌梗死合并心源性休克IABP辅助时机早起预警研究项目(2024J0308);云南省心血管病临床医学中心项目(202002AA310100-07);云南省心血管系统疾病临床医学研究中心-重大心血管疾病诊治新技术研发平台项目(202102AA31002)。

摘　　要：Lambl’s赘生物(LEs)是长条形的瓣膜状突起,具有移动性,通常位于心脏瓣膜间的闭合处。这些丝状的突起细长而柔软,在主动脉瓣和二尖瓣附近最为常见,但也可能出现在其他位置。经食管超声心动图检查可用于检测LEs。左心瓣膜闭合线的高压力可能导致内膜撕裂或损伤,从而引发LEs。本病例报道1例急性非ST段抬高型心肌梗死的患者,同时超声心动图在主动脉瓣的无冠瓣上发现LEs。这种特定的解剖位置给经皮冠状动脉介入治疗(PCI)带来了重大挑战,因为需要指引导管与主动脉瓣直接接触,增加了LEs脱落的风险。幸运的是,此次成功地完成了PCI,随访12个月未发生明显的并发症或栓塞事件。The Lambl's excrescences(LEs) are elongated valvular fronds with excessive mobility,commonly found at the closure lines of heart valves.These filiform projections are thin and long,exhibiting undulating independent motion.LEs predominantly occur on the ventricular side of the aortic valve and on the atrial side of the mitral valve,although there have been documented cases involving tricuspid,pulmonic,and prosthetic valves.To detect LEs,transesophageal echocardiography is often recommended.The high stress experienced by left-sided valves during closure can lead to tears or lesions in the endocardium that initiate LEs pathogenesis.In this particular case study,we present a patient who presented with acute non-ST-segment elevation myocardial infarction alongside LEs located on the non-coronary cusp of the aortic valve.This specific anatomical location posed significant challenges during percutaneous coronary intervention(PCI),as it required direct contact between the guiding catheter and the aortic valve,thereby increasing the risk of dislodging the LEs.Fortunately,our team successfully performed PCI without encountering any notable complications or embolic events.

关 键 词：Lambl’s赘生物 经皮冠状动脉介入治疗 急性非ST段抬高型心肌梗死 

分 类 号：R54[医药卫生—心血管疾病]