Coronary stenting in an elderly patient with an acute myocardial infarction at left main trunk.
Acute myocardial infarction (AMI) caused by an occlusion of the left main trunk (LMT) is a rare angiographic finding. The prognosis is usually extremely poor, particularly in an elderly patient, unless complete reperfusion is rapidly established. We experienced a survival case of an elderly man with AMI at the LMT. A 91-year-old man with cardiogenic shock was referred to our hospital for the treatment of AMI. Left ventriculograms showed that akinesis in the anterolateral and apical wall segments had resulted in an ejection fraction of 30.8%. Coronary angiograms revealed a 90% narrowing at the ostium of the LMT. Intravascular ultrasound images showed a circumferential calcification at the site of the minimum lumen diameter of the LMT. We successfully dilated this calcified narrowing using a coronary stent, and the patient was discharged without complications 1 month later. The patient was asymptomatic 6 months later.
Sakurai
Keita
K
Division of Cardiology, Toyokawa City Hospital, Toyokawa, Japan.
Suzuki
Takeshi
T
Nakazawa
Ai
A
Okado
Tateo
T
Sugiura
Tomonori
T
Ikeda
Koshiro
K
Ueda
Ryuzo
R
Dohi
Yasuaki
Y
D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000628:therapy; D004562:Electrocardiography; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D012770:Shock, Cardiogenic / Q000209:etiology; D015607:Stents; D013318:Stroke Volume; D018084:Ultrasonography, Interventional