İlhan GÖLBAŞI, Ömer BAYEZİD, Ercan AKBULUT, Mehmet KABUKÇU, Oktay SANCAKTAR, Cengiz TÜRKAY

Akut inferior miyokard infarktüsü ile komplike aorta diseksiyonunda girişimsel ve cerrahi kombine tedavi

Akut aort diseksiyonuna sekonder akut miyokard infarktüsü diseksiyonun koroner arterlere yayılmasına veya hematomun koroner arterleri kompresyona uğratmasına bağlı olarak gelişebilmektedir ve mortalitesi yüksektir. 44 yaşındaki erkek hasta, ani başlayan şiddetli göğüs ağrısı nedeniyle hospitalize edildi. Elektrokardiyografide, akut inferior miyokard infarktüsü ve anjiografide ise assendan aorta diseksiyonuna bağlı sağ koroner arterde oklüzyon saptandı. Sağ koroner artere üç adet stent implantasyonu ile reperfüzyon sağlandı. Assendan aortaya, Dakron greft replase edildi. Postoperatif sorunsuz seyreden olgumuz postoperatif dokuzuncu günde taburcu edildi. Aort diseksiyonuna bağlı akut miyokard infarktüsü cerrahi tedavi uygulanıncaya kadar irreversibl komplikasyonlar gelişmeden önce intrakoroner stent ile başarılı şekilde tedavi edilmektedir.

Invasive and surgical combined treatment of acute inferior myocardial infarction complicated ascendan aortic dissection

Acute myocardial infarction secondary to aortic dissection may occur due to compression of the coronary arteries by hemotoma or extension of the dissection into the coronary arterial wall and present high mortality. The patient 44 year old- man was admitted to the hospital because of suddenly manifested severe chest pain. ECG demonstrated acute inferior myocardial infarction, and angiography revealed the right coronary artery occlusion due to ascending aortic dissection. Reperfusion was performed by three stents had been implanted to the right coronary. After that, Dacron graft was replaced to the ascending aorta. The postoperative course was uneventful and the patient was discharged from hospital on the 9th postoperative day. Acute myocardial infarction secondary to aortic dissection before irreversible complications can be succesfully managed by intracoronary stenting until the surgical treatment.

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