导管塑型技术在起源于左Valsalva窦的右冠状动脉病变患者经皮冠状动脉介入治疗中的应用效果:单中心经验Application Effect of Catheter Molding Technology on PCI in Right Coronary Artery Lesion Patients with Origin of Left Sinus of Valsalva:a Single-center Experience
刘涛;周鹏;王昌明;
摘要(Abstract):
目的分析导管塑型技术在起源于左Valsalva窦的右冠状动脉病变患者经皮冠状动脉介入治疗(PCI)中的应用效果。方法 2016年1月—2018年5月在成都医学院第一附属医院行冠状动脉造影患者共3 756例,其中10例为起源于左Valsalva窦的右冠状动脉病变患者,均在行PCI过程中使用导管塑型技术。分析10例患者临床资料及介入治疗情况。结果本组患者中男性5例,女性5例;平均年龄(71.6±6.2)岁;异常起源位置:窦脊上3例,窦脊下7例;病变部位:右冠状动脉中段6例,右冠状动脉开口4例;病变狭窄程度:完全闭塞6例,狭窄率为95%2例,狭窄率为90%2例;行PCI路径:股动脉2例,桡动脉8例;塑型的引导导管:JL 3.5 4例,JL 4.0 6例;平均操作时间(62.1±13.9)min;平均透视时间(18.0±5.1)min;平均射线剂量(3 085.60±1 269.75)m Gy;PCI成功10例;术后无一例患者出现并发症。结论将采用导管塑型技术塑型后的JL 3.5或4.0引导导管用于起源于左Valsalva窦的右冠状动脉病变患者PCI中安全、有效。
关键词(KeyWords): 右冠状动脉起源异常;左Valsalva窦;导管塑型技术;经皮冠状动脉成形术
基金项目(Foundation):
作者(Author): 刘涛;周鹏;王昌明;
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DOI:
参考文献(References):
- [1]KIMBIRIS D,ISKANDRIAN A S,SEGAL B L.Anomalous aortic origin of coronary arteries[J].Circulation,1978,58(4):606-615.
- [2]QAYYUM U,LEYA F,STEEN L,et al.New catheter design for cannulation of the anomalous right coronary artery arising from the left sinus of Valsalva[J].Catheter Cardiovasc Interv,2003,60(3):382-388.
- [3]JAFARY F H.When one won't do it,use two-double “buddy”wiring to facilitate stent advancement across a highly calcified artery[J].Catheter Cardiovasc Interv,2006,67(5):721-723.
- [4]MAMAS M A,FATH-ORDOUBADI F,FRASER D G.Distal stent delivery with Guideliner catheter:first in man experience[J].Catheter Cardiovasc Interv,2010,76(1):102-111.DOI:10.1002/ccd.22458.
- [5]刘涛,周鹏,陈宏.5F TigerⅠ导管塑形技术在复杂冠状动脉造影中应用的效果[J].中华心血管病杂志,2018,(6):458-463.
- [6]PELLICCIAA,SPATAROA,MARONBJ.Prospective echocardiographic screening for coronary artery anomalies in 1,360elite competitive athletes[J].Am J Cardiol,1993,72(12):978-979.
- [7]ZEPPILLI P,DELLO RUSSO A,SANTINI C,et al.In vivo detection of coronary artery anomalies in asymptomatic athletes by echocardiographic screening[J].Chest,1998,114(1):89-93.
- [8]TOPAZ O,DEMARCHENA E J,PERIN E,et al.Anomalous coronary arteries:angiographic findings in 80 patients[J].Int J Cardiol,1992,34(2):129-138.
- [9]CHEITLIN M D,DE CASTRO C M,MCALLISTER H A.Sudden death as a complication of anomalous left coronary origin from the anterior sinus of Valsalva,A not-so-minor congenital anomaly[J].Circulation,1974,50(4):780-787.
- [10]FRESCURA C,BASSO C,THIENE G,et al.Anomalous origin of coronary arteries and risk of sudden death:a study based on autopsy population of congenital heart disease[J].Hum Pathol,1998,29(7):689-695.
- [11]TAYLOR A J,ROGAN K M,VIRMANI R.Sudden cardiac death associated with isolated congenital coronary artery anomalies[J].J Am Coll Cardiol,1992,20(3):640-647.
- [12]KANG W C,AHN T H,SHIN E K.Successful percutaneous coronary intervention for severe stenosis of an anomalous left coronary artery originating from the proximal right coronary artery[J].J Invasive Cardiol,2006,18(5):E154-156.
- [13]SARKAR K,SHARMA S K,KINI A S.Catheter selection for coronary angiography and intervention in anomalous right coronary arteries[J].J Interv Cardiol,2009,22(3):234-239.DOI:10.1111/j.1540-8183.2009.00463.x.
- [14]SARKAR K,SHARMA S K,KINI A S.Catheter selection for coronary angiography and intervention in anomalous right coronary arteries[J].J Interv Cardiol,2009,22(3):234-239.DOI:10.1111/j.1540-8183.2009.00463.x.
- [15]THOMASJA,PATELJ,LATIFF.Successfulcoronary intervention of circumflex artery originating from an anomalous left main coronary artery using a novel support catheter:a case report and review of literature[J].J Invasive Cardiol,2011,23(12):536-539.
- [16]LIN C C,YEH K H,CHOU H H,et al.A Novel Technique for Percutaneous Coronary Intervention for Anomalous Right Coronary Artery Arising from the Left Sinus of Valsalva[J].Acta Cardiol Sin,2015,31(3):235-240.
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