高龄冠状动脉左主干病变合并心源性休克直接PCI治疗2例并文献复习

目的探讨左主干病变导致急性心肌梗死合并心源性休克的高龄（年龄≥75岁）患者在主动脉内球囊反搏（intra-aortic balloon pump,IABP）支持下经皮冠状动脉介入（percutaneous coronary intervention,PCI）治疗的可行性。方法回顾性分析2例90岁以上高龄左主干病变合并心源性休克患者在IABP支持下行直接PCI治疗的临床资料并复习相关文献。结果在给予IABP支持下,PCI治疗可恢复灌注以纠正休克,患者血流动力学和神经病学恢复正常,住院期间存活良好。结论在IABP支持下,直接PCI治疗可以拯救高龄患者生命并改善预后,是一种安全有效的临床选择。

Primary percutaneous coronary intervention for elderly patients with left main coronary artery disease complicated by cardiogenic shock: 2 case studies and literature review

Objectives To explore the feasibility of primary percutaneous coronary intervention(PCI) with intra-aortic balloon pump(IABP) support for elderly patients(≥75 years old) with acute myocardial infarction(AMI) complicated by cardiogenic shock induced by left main coronary artery disease.Methods Clinical data of 2 patients over 90 years old received primary PCI with IABP support on left main coronary artery disease complicated by cardiogenic shock were retrospectively analyzed and literature was reviewed.Results With IABP support,primary PCI could cure cardiogenic shock with reperfusion recovery.The 2 patients recoverd in terms of hemodynamics and neurologics,ang had better clinical outcomes in hospital.Conclusions Primary PCI with IABP support might be a safe and effective treatment providing a strategy to save lives in elderly patients and improve clinical outcomes.