Thoughts triggered by a case of emergency drug balloon angioplasty for acute inferior myocardial infarction with right coronary artery opening into the left sinus
右冠开口于左窦合并急性下壁心肌梗死行急诊药物球囊扩张成形术1例引发的思考

摘要

探讨右冠状动脉开口于左冠窦解剖变异合并急性下壁ST段抬高型心肌梗死的急诊诊疗及介入手术要点。回顾性分析1例55岁女性右冠开口于左窦合并急性下壁心肌梗死患者的临床资料，患者急诊行冠脉造影明确病变后，经升主动脉造影定位血管开口，成功行药物球囊扩张成形术（DCB），术后恢复良好出院。右冠开口于左窦合并急性心肌梗死时急诊介入手术难度高，快速识别解剖变异、精准定位血管开口、规范器械操作是手术成功关键，术后强化二级预防可改善患者预后。

Abstract

This article discusses the emergency diagnosis, treatment, and key points of interventional surgery for acute inferior ST-segment elevation myocardial infarction (STEMI) with anatomical variation of the right coronary artery (RCA) opening into the left coronary sinus (LCS). A retrospective analysis is conducted on the clinical data of a 55-year-old female patient with RCA opening into the LCS and acute inferior STEMI. After undergoing emergency coronary angiography to confirm the lesion, the patient underwent ascending aorta angiography to locate the vascular opening, and successful drug-eluting balloon angioplasty (DCB) was performed. The patient recovered well and was discharged after surgery. Emergency interventional surgery for RCA opening into the LCS with acute myocardial infarction is challenging. Rapid identification of anatomical variations, precise localization of the vascular opening, and standardized device operation are key to successful surgery. Postoperative secondary prevention can improve patient prognosis.