经皮冠状动脉介入术治疗冠状动脉左主干病变疗效观察

目的 观察经皮冠状动脉介入术(PCI)治疗无保护冠状动脉左主干(ULMCA)病变的疗效.方法 对40例ULMCA病变患者采用PCI治疗,随访6～20个月,观察心血管不良事件(MACE)的发生情况.结果 所有患者经PCI治疗即时成功率100.0％,术中无严重并发症.住院期间未发生严重心血管不良事件.术后随访6～20(7±2)个月,术后4周发生急性心肌梗死l例,CAG证实回旋支开口亚急性支架内血栓形成,再次PCI治愈；术后动员28例患者在6～12个月进行CAG复查,其中回旋支开口支架内再狭窄3例,左主干远端-前降支开口再狭窄1例,2例再狭窄患者有心绞痛症状,3例再次行PCI,无需要CABG患者.随访期间无死亡病例.心血管不良事件总的发生率12.5％ (5/40),再狭窄率10.0％(4/40).结论 对经过选择的ULMCA病变进行PCI是安全可行的,有良好的近远期预后.

Effect of percutaneous coronary artery interventional therapy on unprotected left main coronary artery disease

Objective To observe the effect of percutaneous coronary intervention（PCI） treatment on unprotected left main coronary artery（ULMCA） lesion. Methods 40 patients with ULMCA lesions treated with PCI were followed up for 6 to 20 months, adverse cardiovascular events （MACE） occurrence were observed. Results All patients treated by immediate PCI success rate was 100.0%. There were no serious complications. There were no serious adverse cardiovascular events during hospitalization. Patients were followed up 6 -20 （7±2 ）months ,4 weeks after op- eration, acute myocardial infarction in 1 case, CAG confirmed circumflex artery open subacute stent thrombosis, re-PCI cure;postoperative mobilization of 28 patients took CAG in 6 - 12 months, including the opening circumflex artery stent restenosis in 3 cases, one distal left anterior descending branch of the trunk opening and then stenosis,2 cases of restenosis in patients with angina symptoms,3 patients re-line PCI, no need to CABG patients. No deaths during followup. The overall incidence of cardiovascular adverse events rate was 12. 5% （5/40）, restenosis rate was 10. 0% （4/40）. Condusion The choice of ULMCA lesions after PCI was safe and feasible,with good short and long term prognosis.