单支开放冠状动脉介入治疗的安全性和疗效评价

Interventional therapy of multivessel disease with single patency coronary artery

目的 观察单支开放冠状动脉介入治疗的即刻效果和远期疗效。方法 回顾性分析1989年 9月至 2 0 0 1年 5月 43例未能做冠状动脉搭桥术的单支开放冠状动脉患者进行介入治疗的即刻效果 ,以及随访一年以上的心血管事件发生率和心功能。结果 43例患者中 40例成功地进行了冠状动脉球囊扩张术或支架植入术 ,近期症状明显缓解 ;住院期间 2例发生急性心肌梗死 ,1例猝死 ,均为血管急性闭塞所致。 34例患者随访 1年以上 ,其中长期症状缓解 2 4例 ,再发心绞痛 8例 ,心肌梗死 1例 ,心功能恶化 1例 (PTCA未成功者 ) ;冠脉造影证实再狭窄 8例 ,新病变 1例 ,2例行冠状动脉搭桥术 ,5例重复PTCA ,1例行激光心肌打孔术。结论 对于不能进行冠状动脉搭桥术的单支冠脉开放患者 ,介入治疗可以改善症状 ,保护心脏功能。

Objective To evaluate the safety and effect of interventional therapy in patients with single patency coronary artery, who cannot treated by CABG Methods Retrospectively analyze the hospital effect and complication of PTCA or stenting in these patients, and followed up more than one year to record cardiac events and heart function Results 43 patients were analyzed One or more vessels of 40 patients were successfully revascularized Two cases of AMI and one case of death happened in hospital because of acute occlusion after PTCA, which were all happened before stent used 34 patients were followed up more than one year 24 patients had no symptom There were 8 cases of angina pectoris and one case of AMI during the period of follow up, 9 restenosis and 1 new lesion were confirmed by angiography The heart function of only one patient went worse, who had a failed PTCA, and CABG could not be made because of other disease Conclusion Interventional therapy is effective on relieving symptom and protecting heart function in patients with single patency coronary artery who cannot undergo CABG, but the rate of complication and restenosis is high