pci冠脈穿孔常見原因和防治策略-預覽頁
【正文】 98 1999 2020 2020a b c i x i m a bn o a b c i x i m a bGunning et al Heart 2020 No. patients with haemodynamically significant coronary perforation Management .. ? Depends on grade / severity Wire perforation ? Often benign ? Often unreported ? hydrophilic wires May respond to ? reversal of heparin ? observation ? balloon tamponade For distal perforations …. ? Coil embolisation ? Adipose tissue ? Bioglue ? polyvinyl alcohol ? autologous blood The covered stent … If there is tamponade … ? Aspirate ….. ? Set up autotransfusion circuit ? monitor drainage ? Do not rely on free drainage ? If not resolving consider surgery 緊急心包穿刺引流技術 — 有效自救 Study Year Emerg surgery Death Von Sohsten 2020 9/15 (60%) 0 Gruberg 2020 33/84 (39%) 6/33 (18%) Fejka 2020 12/31 (39%) 6/12 (50%) Fukutomi 2020 2/69 (3%) 0 Gunning 2020 8/52 (15%) 3/8 (38%) Witzke 2020 2/39 (%) 1/2 (50%) perforation Surgery So surgery not definitive solution to the problem 非 外科 手術治療 ? 持續(xù)低壓球囊擴張，需長時間擴張時使用灌注球囊防止心肌缺血。 ? 栓塞治療。 預祝：所有患者和術者 Lucky??！ Thank you
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