Reversible left anterior descending artery spasm, prolonged cardiac arrest and left main thrombosis during a PTCA attempt of the circumflex artery.
The authors report a case of percutaneous transluminal coronary angioplasty of the circumflex artery complicated by occlusion of the non-diseased left anterior descending artery by spasm. During advanced cardiac life support, required for the subsequent cardiac arrest, intra-coronary nitrates and calcium antagonists were administered. After 45 minutes, the spasm resolved, but N probably as a result of prolonged blood stasis N a thrombus appeared in the left main artery. While attempting to stent the left main, the thrombus was mechanically dislodged, leaving the epicardial coronary tree free, with a good flow.
Trani
C
C
Cardiology, Catholic University, L.go A. Gemelli, 8, 00168, Rome, Italy. carlotrani@iol.it.
Burzotta
F
F
Andreotti
F
F
Colizzi
C
C
Rebuzzi
A G
AG
Schiavoni
G
G
Mazzari
M A
MA
D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D017023:Coronary Angiography; D003328:Coronary Thrombosis / Q000209:etiology*; D003329:Coronary Vasospasm / Q000209:etiology*; D004562:Electrocardiography; D006323:Heart Arrest / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013997:Time Factors