Urgent Off-Pump Revascularisation in ACS and Cardiogenic Shock with Anomalous Origin of Right Coronary Artery from Left Anterior Descending Artery: A Case Report  

作　　者：Surabhi Puri Somya Puri Deepak Puri Surabhi Puri;Somya Puri;Deepak Puri(Department of Community Medicine, AIIMS, New Delhi, India;Maharishi Markandeshwar Medical College and Hospital, Solan, India;Department of CTVS, Max Superspeciality Hospital, Mohali, India)

机构地区：[1]Department of Community Medicine, AIIMS, New Delhi, India [2]Maharishi Markandeshwar Medical College and Hospital, Solan, India [3]Department of CTVS, Max Superspeciality Hospital, Mohali, India

出　　处：《World Journal of Cardiovascular Diseases》2021年第8期372-377,共6页心血管病（英文）

摘　　要：A 55-year-old female known case of essential hypertension and diabetes was brought to the Emergency Department in a drowsy state with cardiogenic shock. At presentation systolic BP was 70 mm Hg, pulse rate was 44/min and random blood sugar was 239 mg/dl. Troponin I was 8.07. Electrocardiography showed junctional rhythm and bradycardia. Ejection Fraction (LVEF) was 15% - 20%. Coronary angiography was done which revealed single vessel disease in LAD with anomalous origin of RCA from midsegment of LAD. Patient was immediately taken up for Off</span></span><span style="white-space:normal;"><span style="font-family:"">-</span></span><span style="white-space:normal;"><span style="font-family:"">pump Coronary Artery Bypass Grafting (OPCAB). Right saphenous vein graft was harvested and anastomosed proximally to aorta and distally to LAD on beating heart using Medtronic Octopus heart stabilizer and coronary shunts. Wound closed in layers after achieving complete hemostasis. Patient was taken off ventilatory support on first post-operative day and discharged in a stable condition on fourth post-operative day. Post-operative Echocardiography showed LVEF increased from 15% - 20% at time of admission to 38% and 52% after 3</span></span><span style="white-space:normal;"><span style="font-family:""> </span></span><span style="white-space:normal;"><span style="font-family:"">months and 12 months of surgery respectively.A 55-year-old female known case of essential hypertension and diabetes was brought to the Emergency Department in a drowsy state with cardiogenic shock. At presentation systolic BP was 70 mm Hg, pulse rate was 44/min and random blood sugar was 239 mg/dl. Troponin I was 8.07. Electrocardiography showed junctional rhythm and bradycardia. Ejection Fraction (LVEF) was 15% - 20%. Coronary angiography was done which revealed single vessel disease in LAD with anomalous origin of RCA from midsegment of LAD. Patient was immediately taken up for Off</span></span><span style="white-space:normal;"><span style="font-family:"">-</span></span><span style="white-space:normal;"><span style="font-family:"">pump Coronary Artery Bypass Grafting (OPCAB). Right saphenous vein graft was harvested and anastomosed proximally to aorta and distally to LAD on beating heart using Medtronic Octopus heart stabilizer and coronary shunts. Wound closed in layers after achieving complete hemostasis. Patient was taken off ventilatory support on first post-operative day and discharged in a stable condition on fourth post-operative day. Post-operative Echocardiography showed LVEF increased from 15% - 20% at time of admission to 38% and 52% after 3</span></span><span style="white-space:normal;"><span style="font-family:""> </span></span><span style="white-space:normal;"><span style="font-family:"">months and 12 months of surgery respectively.

关 键 词：Right Coronary Artery Anomalous Origin Left Coronary Artery 

分 类 号：R54[医药卫生—心血管疾病]