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目的 :探讨无保护左主干病变患者冠状动脉 (冠脉 )内支架术的近、远期疗效。方法 :共选择 8例均无冠脉搭桥术史的左主干病变患者行冠脉内支架术 ,其中左主干近中段病变 5例 ,远段分叉病变 3例 ,其中 2例的左室射血分数 <4 0 % ,总结分析其临床、左主干病变特点、手术成功率及随访结果。结果 :左主干支架术的成功率为 10 0 % ,无残余狭窄或残余狭窄率 <10 % ,无任何严重并发症如支架内血栓形成、急性心肌梗死、紧急外科冠脉搭桥术或死亡等。术后随访 5～ 15 (10± 3.5 )个月 ,无一例死亡。临床心绞痛复发 1例 ,重复冠脉造影证明为前降支的新生病变所致 ;2例左室功能不全患者的左室射血分数提高了 15 %以上 ;5例复查了冠脉造影 ,其中 4例的原支架内基本无再狭窄 ;1例有 30 %再狭窄 (为前述症状复发的患者 )。结论 :支架置入术治疗无保护左主干病变疗效显著 ,是值得考虑的治疗手段 ;正确的病例选择和娴熟的操作技巧是手术成功的关键
Objective: To investigate the short-term and long-term effects of coronary (coronary) stenting in patients with unprotected left main disease. Methods: A total of 8 patients with left main coronary artery disease who had no history of coronary artery bypass grafting underwent coronary stenting. Among them, 5 were in the proximal middle part of the left main trunk and 3 were in the distal segmental bifurcation lesion. 2 of them were left ventricular ejection Score <40%, summarizes the clinical features of the left main lesion, the success rate of surgery and follow-up results. RESULTS: The success rate of the left main stent was 100% with no residual stenosis or residual stenosis <10% without any serious complications such as stent thrombosis, acute myocardial infarction, emergency surgical bypass or death. All patients were followed up for 5 ~ 15 (10 ± 3.5) months without any death. One case of clinical angina recurrence, repeated coronary angiography proved to be caused by a new lesion of the anterior descending artery; 2 cases of left ventricular dysfunction in patients with left ventricular ejection fraction increased by 15% or more; 5 cases were reviewed coronary angiography, of which 4 In the original stent, there was almost no restenosis. One case had 30% restenosis, which was the recurrence of the above symptoms. Conclusion: Stent placement is an effective treatment for unprotected left main disease and is worth considering. The correct choice of case and skillful operation skills are the keys to successful operation