左心室收缩功能显著减退患者行冠状动脉旋磨术的安全性分析

目的：探讨严重左心室收缩功能减退患者行冠状动脉（冠脉）旋磨手术的安全性。方法：选取2016年1月至2019年12月复旦大学附属中山医院心内科收治的行冠脉旋磨手术的冠心病患者14例，观察手术的成功率和围手术期并发症。结果：患者平均年龄为（68.5±8.6）岁，左心室射血分数为（31.4±2.6）%。平均需（4.9±2.4）次旋磨通过病变，平均最高旋磨速度为（18.2±1.8）×10⁴ r/min。所有患者成功植入药物洗脱支架，平均植入（2.9±1.2）枚。旋磨术后发生慢血流1例（7.1%），冠脉夹层2例（14.3%），冠脉痉挛2例（14.3%），均为弥漫钙化病变且经多次旋磨处理，经药物治疗或植入支架解决，无冠脉穿孔、心包填塞、紧急外科手术、死亡发生。住院期间无严重心脏不良事件发生。结论：在左心室收缩功能显著减退患者中行冠脉旋磨手术安全性良好。

Safety of coronary rotablation in patients with significant left ventricular systolic dysfunction

Objective:To explore the safety of coronary rotablation in patients with severe left ventricular systolic dysfunction. Methods:From January 2016 to December 2019, 14 patients undergoing coronary rotablation in Zhongshan Hospital were retrospectively enrolled in this study. Results:Average age of patients were (68.5±8.6) years old, and mean LVEF was (31.4±2.6)%. It took (4.9 ±2.4) times to pass through the lesion, and the average maximal speed was (18.2±1.8)×10⁴ r/min. Drug eluting stents were successfully implanted in all patients, with an average of (2.9±1.2) stents per patient. One case (7.1%) developed slow blood flow, 2 cases (14.3%) developed coronary artery dissection, and 2 cases (14.3%) developed coronary spasm. All of them were diffuse calcified lesions, which were resolved by drug treatment or stent implantation. No coronary perforation, pericardial tamponade, emergency surgery or death occurred. No major adverse cardiac events occurred during hospitalization. Conclusions:Coronary rotablation in patients with severe left ventricular systolic dysfunction was safe.