目的:观察再血管化(revascularization)治疗对冠状动脉慢性完全闭塞病变患者心功能的影响。方法:对经冠状动脉造影证实的冠状动脉发生慢性完全闭塞(chronic total occlusion)的30例患者采用冠状动脉介入治疗(PCI:PTCA加支架植入术)或冠...目的:观察再血管化(revascularization)治疗对冠状动脉慢性完全闭塞病变患者心功能的影响。方法:对经冠状动脉造影证实的冠状动脉发生慢性完全闭塞(chronic total occlusion)的30例患者采用冠状动脉介入治疗(PCI:PTCA加支架植入术)或冠状动脉旁路搭桥术(CABG)进行再血管化,在治疗前和治疗后3～6个月根据心脏超声和临床表现评价心功能状态。结果:PCI组18例治疗显效14例(77.7％),有效3例(16.6％),无效1例(5.6％),总有效率94.4％;CABG组12例显效9例(75.0％),有效2例(16.7％),无效1例(2.3％),总有效率91.6％,两组治疗前后心功能改善均具有统计学上的显著差异(P<0.01)。结论:PCI和CABG使冠心病患者的冠状动脉慢性完全闭塞病变再血管化,能够改善心功能状态。展开更多
慢性完全闭塞冠状动脉病变(chronic total occlusion,CTO)是指冠状动脉粥样硬化导致冠状动脉完全闭塞,时间大于3月的病变[1]。研究证实,成功开通CTO病变,可以改善患者左心室功能,提高生存质量,缓解症状,提高生存率[2]。近年来,新一代准...慢性完全闭塞冠状动脉病变(chronic total occlusion,CTO)是指冠状动脉粥样硬化导致冠状动脉完全闭塞,时间大于3月的病变[1]。研究证实,成功开通CTO病变,可以改善患者左心室功能,提高生存质量,缓解症状,提高生存率[2]。近年来,新一代准分子激光冠脉成形术(excimer laser coronary atherectomy,ELCA)被国外临床应用于治疗CTO和其他复杂血管病变,ELCA使用更短波长的紫外线光源和更细的导管设计及脉冲术发射的冷光源,使手术的有效性、安全性明显提高,已取得显著成效[3]。但目前国内应用较少。2018年2 ~ 8月,本院对2例CTO患者使用ELCA进行治疗手术成功,经过对CTO患者围术期精心的护理,取得了良好的效果,现报道如下。展开更多
Ostial lesions present many challenges for percutaneous coronary intervention （PCI）. Coronary anomaly will further increase difficulties in performing PCI for the patient. We present such a case as ostial occlusion ...Ostial lesions present many challenges for percutaneous coronary intervention （PCI）. Coronary anomaly will further increase difficulties in performing PCI for the patient. We present such a case as ostial occlusion of an right coronary artery with high takeoff. A 77-year-old male was referred to our institution with a diagnosis of non-ST elevated acute myocardial infarction. Selective coronary angiography and nonselective ascending aortography could not identify the origin of the right coronary artery. Multi-slices computed tomography showed RCA ostial totally occluded. A successful PCI was performed and a perfect final result was achieved utilized with many tips and tricks, including buddy wtre technique and focused-force angloplasty（J Genatr Cardio12009, 6：189-192）.展开更多
文摘目的:观察再血管化(revascularization)治疗对冠状动脉慢性完全闭塞病变患者心功能的影响。方法:对经冠状动脉造影证实的冠状动脉发生慢性完全闭塞(chronic total occlusion)的30例患者采用冠状动脉介入治疗(PCI:PTCA加支架植入术)或冠状动脉旁路搭桥术(CABG)进行再血管化,在治疗前和治疗后3～6个月根据心脏超声和临床表现评价心功能状态。结果:PCI组18例治疗显效14例(77.7％),有效3例(16.6％),无效1例(5.6％),总有效率94.4％;CABG组12例显效9例(75.0％),有效2例(16.7％),无效1例(2.3％),总有效率91.6％,两组治疗前后心功能改善均具有统计学上的显著差异(P<0.01)。结论:PCI和CABG使冠心病患者的冠状动脉慢性完全闭塞病变再血管化,能够改善心功能状态。
文摘Ostial lesions present many challenges for percutaneous coronary intervention （PCI）. Coronary anomaly will further increase difficulties in performing PCI for the patient. We present such a case as ostial occlusion of an right coronary artery with high takeoff. A 77-year-old male was referred to our institution with a diagnosis of non-ST elevated acute myocardial infarction. Selective coronary angiography and nonselective ascending aortography could not identify the origin of the right coronary artery. Multi-slices computed tomography showed RCA ostial totally occluded. A successful PCI was performed and a perfect final result was achieved utilized with many tips and tricks, including buddy wtre technique and focused-force angloplasty（J Genatr Cardio12009, 6：189-192）.
