急性心肌梗死左主干加三支病变急诊PCI后CABG 1例

One case about acute myocardial infarction which proved to be left main with three vessel disease take emergency PCI then elective CABG

急性心肌梗死合并心源性休克是心肌梗死最严重的后果之一,处理困难。急诊冠状动脉造影证实,急性心肌梗死合并心源性休克患者常表现为多支血管病变,但对于这类患者最佳的血运重建方案仍不明确,梗死相关血管再灌注及早期血流动力学稳定是治疗的关键。多数情况下,经皮冠状动脉支架置入术和冠状动脉旁路移植术两种血运重建方案的安全复合终点相似,每例患者具体实施何种方案,既要参考患者的意愿,又要考虑手术的安全性以及近期和远期疗效,以期达到最佳治疗效果。

Acute myocardial infarction complicated with cardiogenic shock is one of the most serious complications and dealt with difficult.Emergency coronary angiography usually presents multivessel disease on acute myocardial in-farction with cardiogenic shock patients,but for these patients the best revascularization solution is still unclear.Infarct-related artery reperfusion,and early hemodynamic stability is the key to treatment.PCI and CABG have the same safe and similar results,the specific implementation plan,which was taken to refer the patient’s wishes,but also to consider the safety of surgery,as well as short-term and long-term efficacy,in order to achieve optimal treatment.