病例报告：急性主动脉夹层术后冠状动脉桥血管内血栓形成一例

A Case Report: One Case of Intravascular Thrombosis in Coronary Artery Bridge after Acute Aortic Dissection Surgery

摘要: 这项研究讨论了一例A型急性主动脉夹层行Bentall + Sun氏术后5个月发生急性心肌梗塞的诊断和治疗过程，以及夹层术后常用的抗凝方案和术后存在的桥血管阻塞风险。因术后冠状动脉及头臂干动脉解剖位置的改变，急诊冠状动脉介入治疗面临了较大困难，同时也面临二次手术的困境。通过术前准确评估，术中正确建立血运，以及术后实施强化抗凝药物治疗，从而尽可能地降低急性心血管事件的风险。

Abstract: This study discusses the diagnosis and treatment process of acute myocardial infarction 5 months after Bentall + Sun surgery for type A acute aortic dissection, as well as the commonly used anticoagulation regimens after dissection and the risk of bridge vessel occlusion after surgery. Due to the changes in the anatomical positions of the coronary arteries and the head and arm trunk arteries after the operation, emergency coronary intervention therapy has encountered considerable difficulties and also faces the predicament of a second operation. Through accurate preoperative assessment, correct intraoperative blood supply establishment, and the implementation of intensive anticoagulant drug treatment after surgery, the risk of acute cardiovascular events can be reduced as much as possible.