Recently, the interventional surgery team of the Third Department of Cardiovascular Medicine of Xi'an Ninth Hospital successfully performed coronary artery stent implantation for a 94-year-old patient with high-risk acute myocardial infarction combined with hypertension and cardiac insufficiency.
Coronary angiography is a common and effective method for the diagnosis and treatment of coronary heart disease, and it is a minimally invasive diagnosis and treatment technique, but cardiac stent implantation for the elderly is still a thrilling "needlepoint dance", and the risks of surgery are self-evident.
On April 17, Grandma Tian suddenly developed chest tightness, difficulty breathing, and inability to lie flat while resting at home, and was admitted to the emergency hospital for the diagnosis of acute non-ST-segment elevation myocardial infarction. The patient is an extremely high-risk case with advanced age, hypertension, hypoxemia, cardiac insufficiency and other diseases, with a GRACE score of 175 points, and the risk of cardiac arrest and sudden death at any time. After the condition is critical, the chief physician of Jinlong evaluates the condition and believes that the patient is in critical condition and the risk of surgery is high, but the patient will face the expansion of the scope of myocardial infarction without surgery, which may be life-threatening, and immediately inform the patient's family of the condition, and the family can fully understand the risk of surgery.
Acute myocardial infarction is complicated by malignant arrhythmia, heart failure, and cardiac rupture at any time, and the mortality and disability rate is extremely high.
Disinfection, towel, catheterization, ECG monitoring, coronary angiography...... The interventional surgery in the catheterization room was carried out quickly, tensely and orderly. Intraoperative angiography showed that the coronary artery was multi-branched and multi-segment extremely severely lesional, the right coronary artery opening was 100% occluded, the guidewire was rapidly dilated through the blockage site, and a stent was successfully implanted, the blood flow was smooth, the patient's symptoms were quickly relieved, and the vital signs were stable.
After the successful interventional surgery, he was transferred to the CCU for close observation, and the postoperative cardiovascular expert team formulated an individualized treatment plan according to the patient's past history and the feedback of routine laboratory indicators, paid close attention to the changes in the patient's condition, and gave psychological counseling and comfort in a timely manner. The successful treatment of this patient demonstrates the comprehensive strength of the three cardiovascular departments in efficient linkage, close cooperation, rapid response, and racing against time to treat critically ill patients.
Jin Long, director of the third cardiovascular department, introduced that the aging of the social population is getting worse and the incidence of acute myocardial infarction is gradually increasing. The majority of elderly patients with cardiovascular diseases should adhere to long-term drug treatment, do not stop taking drugs at will without special circumstances, need to go to the outpatient clinic for regular review, make timely adjustments to the drug according to the changes in the condition, usually avoid overwork, emotional excitement, cold stimulation, excessive satiety, smoking and drinking and other predisposing factors, and actively control blood pressure, blood sugar, blood lipids, delay the progression of cardiovascular disease and prevent recurrence.
Chinese business all-media reporter Chen Mengyang
According to the Ninth Hospital of Xi'an