本特尔手术后冠状动脉功能不全致难治性心室颤动1例。

IF 1 4区医学 Q3 MEDICINE, GENERAL & INTERNAL

World Journal of Clinical Cases Pub Date : 2025-08-16 DOI:10.12998/wjcc.v13.i23.106886

Min Zhu, Miao-Miao Tang, Rong-Hua Zhou

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引用次数: 0

摘要

背景：在需要体外循环（CPB）的心内直视手术中，心室颤动（VF）是常见的，但难治性复发性VF不常见但危险。病例总结：本文报告一名58岁男性升主动脉瘤患者，行本特尔手术，随后在CPB断奶后多次出现不明原因的室性心动过速。本病例反复发作的室性心动过速被认为与主动脉根重建后冠状动脉功能不全有关。右冠状动脉近端和左前降支冠状动脉旁路移植术（CABG）成功解决了室性心动过速。最后，该患者安全转入术后重症监护病房，并在后续支持治疗后顺利出院。结论：在主动脉根置换术中，冠状动脉功能不全是导致VF发作的潜在原因，在鉴别诊断中应予以考虑。冠脉搭桥是治疗冠状动脉功能不全引起的室颤的唯一有效方法。

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Refractory ventricular fibrillation caused by coronary insufficiency after Bentall procedure: A case report.

Background: In open heart surgery requiring cardiopulmonary bypass (CPB), ventricular fibrillation (VF) is common, but refractory recurrent VF is uncommon but perilous.

Case summary: This article reports a 58-year-old male patient with an ascending aortic aneurysm who presented for a Bentall procedure and subsequently experienced multiple occurrences of unexplained VF after weaning from CPB. The recurrent episodes of VF in this case were felt to be related to coronary insufficiency after reconstruction of the aortic root. Coronary artery bypass grafting (CABG) of the proximal right coronary artery and the left anterior descending artery successfully resolved VF. Finally, this patient was safely transferred to the postoperative intensive care unit, and was discharged successfully after subsequent supportive treatment.

Conclusion: In aortic root replacement, coronary insufficiency is a potential cause of VF episodes and should be considered in the differential diagnosis. CABG is the sole effective treatment for VF caused by coronary insufficiency.

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来源期刊

World Journal of Clinical Cases Medicine-General Medicine

自引率

0.00%

发文量

3384

期刊介绍： The World Journal of Clinical Cases (WJCC) is a high-quality, peer reviewed, open-access journal. The primary task of WJCC is to rapidly publish high-quality original articles, reviews, editorials, and case reports in the field of clinical cases. In order to promote productive academic communication, the peer review process for the WJCC is transparent; to this end, all published manuscripts are accompanied by the anonymized reviewers’ comments as well as the authors’ responses. The primary aims of the WJCC are to improve diagnostic, therapeutic and preventive modalities and the skills of clinicians and to guide clinical practice in clinical cases.