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Eur Heart J：欧洲心脏杂志刊登深圳医生病例，小血管闭塞，也引发大灾难

2018-11-23 文韬 中国循环杂志

单纯间隔支闭塞室间隔穿孔经皮封堵
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室间隔穿孔几乎都是大冠状动脉病变导致的，而这是第一例单纯间隔支闭塞引发心脏破裂的首次报告，该病例通过使用经皮封堵治疗成功。

深圳孙逸仙心血管医院医生在欧洲心脏杂志报告：单纯间隔支闭塞也可引发室间隔穿孔。

作者称，室间隔穿孔几乎都是大冠状动脉病变导致的，而这是第一例单纯间隔支闭塞引发心脏破裂的首次报告，该病例通过使用经皮封堵治疗成功。

一名65岁男士患有3天来呼吸困难、心悸。

入院血压偏低，92/60 mmHg，并有心动过速。

心电图显示V1-4导联的ST段抬高。肌钙蛋白轻度升高。

超声心动图显示室间隔穿孔，左右心室孔的最大直径分别为2.1 cm和0.8 cm。

彩色多普勒显示左右心室之间的双向分流（图D和E）。左心室没有室壁运动异常，射血分数约为70%。

冠状动脉造影显示，第一间隔支完全闭塞（图F），通过球囊血管成形术（图G）成功治疗，在左前降支中远段有中等程度病变。

入院后，患者病情恶化，复查超声心动图示破裂增大（图H和I）。

随后使用了静脉注射药物和主动脉内球囊泵进行稳定。

入院后2个月，使用1618 mm HeartR™封堵器（LifeTech Scientific Corporation，深圳，中国）进行了经皮封堵缺损，术后有小的残余分流（图J-L）。

在6个月的随访中，病人无症状。



原始出处：
Xinbo Zhong  Guili Zhou  Zhifu Huan, et al. Small septal vessel occlusion results in big damage: ventricular septal dissection and rupture. European Heart Journal, Volume 39, Issue 26, 7 July 2018.

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    2019-06-25 cnxcy

    #血管闭塞#

    0

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    2018-11-25 ms9474365431325850

    #欧洲#

    0

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    2018-11-25 zhaojie88

    #ART#

    0

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    2018-11-25 slcumt

    #HEART#

    0

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    2018-11-24 医者仁心5538

    临床上很少见到这类病人

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=2009848, encodeId=87f7200984818, content=<a href='/topic/show?id=467789803a9' target=_blank style='color:#2F92EE;'>#血管闭塞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89803, encryptionId=467789803a9, topicName=血管闭塞)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=827b160, createdName=cnxcy, createdTime=Tue Jun 25 08:28:00 CST 2019, time=2019-06-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1339141, encodeId=5dc11339141ed, content=<a href='/topic/show?id=447663054f5' target=_blank style='color:#2F92EE;'>#欧洲#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63054, encryptionId=447663054f5, topicName=欧洲)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/PiajxSqBRaEKxsKDoOOFxGpMibw6lsQFUIicWt7kWGevkdgFhjiban1icD2JdIBmjVo7qX7aSlCSpiaia382nuLKiaI3Cg/132, createdBy=5c442500150, createdName=ms9474365431325850, createdTime=Sun Nov 25 13:28:00 CST 2018, time=2018-11-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1357007, encodeId=d95a135e0079d, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Sun Nov 25 13:28:00 CST 2018, time=2018-11-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1563007, encodeId=2741156300eb1, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Sun Nov 25 13:28:00 CST 2018, time=2018-11-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=353539, encodeId=2a2535353934, content=临床上很少见到这类病人, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=82311653708, createdName=医者仁心5538, createdTime=Sat Nov 24 12:56:53 CST 2018, time=2018-11-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=353523, encodeId=ac9c353523ad, content=学习了很有用, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib3IzoRn621JdKCFUI4XvNELcibocrAVU6aUzEVDSaf3rYH08PUYUiagGqxAEhj8g9WqqNvD1CupIpCrmnR2OrqHZh/0, createdBy=7f181365728, createdName=飛歌, createdTime=Sat Nov 24 09:29:02 CST 2018, time=2018-11-24, status=1, ipAttribution=)]
    2018-11-24 飛歌

    学习了很有用

    0