无保护左冠状动脉主干病变的支架术治疗

Selected Coronary Artery Stenting on Unprotected Left Main Coronary Artery Disease

目的 :探讨无保护左主干病变PTCA和支架术治疗的经验及疗效。方法 :选择 5例经冠状动脉造影证实的左主干病变及或合并其它三支冠脉病变的患者 ,其中 3例有不同程度的心功能不全 ,3例有恶化劳累性心绞痛 ,2例有心肌梗死史 ,2例合并有高血压病。入院常规心脏彩超检查评价左室射血分数 (LVEF)。术中常规造影 ,正确快速完成PTCA和支架植入术 ,其中 2例行直接支架植入术 ,3例行球囊扩张后 ,再植入支架。术后观察分析临床疗效 ,手术成功率 ,并发症及随访结果。结果 :5例左主干病变的PTCA和支架植入均获得成功 ,手术成功率 10 0 %。术后临床症状明显改善 ,无严重并发症发生 ,随访 3.5± 0 .5个月 ,无 1例复发或死亡 ,心功能明显改善 ,劳动耐受力及生活质量明显提高。结论 :择期无保护左主干病变支架术治疗在经验丰富。

Objective:To investigate the experience and efficacy of selected coronary artery stenting on unprotected left main disease. Methods:Five patients who were angiographically diagnosed left main diseases merged with lesions of other cardial adventic arteries were enrolled and 3 cases had variantly degree cardiac dysfunction.3 cases had severe angina,2 cases were found with myocardial infarction and 2 cases with hypertension.The angiography was routinely operated and the percutaneous transluminal coronary angioplasty(PTCA) and implantation of coronary stents were finished rapidly and successfully in all cases.Two cases were primarily deployed stents and 3 was given PTCA before deployment of coronary stents.Thereafter,clinical characteristics,severe complications and the results of following up were analyzed respectively.Results:The success rate of the procedure was 100%. Clinical symptoms were obviously ameliorated. No severe complication was found. The averaged time of following up was(3.5±0.5)months.There was none of death or recurrent angina, and the cardiac function was improved.Conclusion:The results suggest that selected coronary artery stenting of unprotected left main disease is safe and efficacious.