[Coronary angioplasty immediately after coronary recanalization in the acute phase of myocardial infarct].
The author report the case of a 48 years old patient, admitted to hospital 3 hours and a half after an anterior myocardial infarct which was well tolerated. Coronary recanalization with urokinase-plasminogen removed the obstruction of the middle part of the anterior interventricular artery 1 hour and a half after the patient's arrival. Selective left coronary angiography demonstrated a narrow stenosis, in the order of 98%, in the proximal part of the AIV artery. Angioplasty was attempted immediately, in view of the ease with which the guide wire was passed through the initial thrombosis and the good haemodynamic tolerance. The residual stenosis was estimated to be 20% after the angioplasty and at the examination 48 hours later. The ECG on discharge from hospital showed a QS appearance in V1 to V3 with R in V4. An improvement in the ejection fraction (EF) and in the end-diastolic volumes was found: EF: 48% compared to 38%, EDV (cc/m2): 79 compared to 120. The clinical course at two months is very satisfactory, with no residual angina and a negative stress test. This special procedure, combining a double therapeutic catheterization, lasted 1 hour 50 minutes and allowed the progression of the myocardial infarction to be halted and also avoided a subsequent aorto-coronary graft operation.
D000800:Angioplasty, Balloon; D017023:Coronary Angiography; D003326:Coronary Circulation / Q000187:drug effects; D004562:Electrocardiography; D010450:Endopeptidases / Q000627:therapeutic use*; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy*; D014568:Urokinase-Type Plasminogen Activator / Q000627:therapeutic use*
D010450:Endopeptidases; D014568:Urokinase-Type Plasminogen Activator
Angioplastie coronarienne immédiatement après recanalisation coronarienne à la phase aiguë de l'infarctus du myocarde.