title: Unprotected left main coronary artery intervention for acute myocardial infarction and cardiogenic shock.
abstract: Medical therapy alone often insufficiently alters the clinical course of patients who have experienced acute myocardial infarction and concomitant cardiogenic shock, and in whom the left main coronary artery is the culprit vessel. Emergency coronary artery bypass grafting is an effective yet time-consuming approach that entails the risk of extensive, irreversible myocardial damage. Percutaneous coronary intervention in the unprotected left main coronary artery can enable initial revascularization and rapid stabilization even in high-risk patients, but outcomes from the procedure since the recent advent of drug-eluting stents are still being determined. Herein, we report the successful deployment of a sirolimus-eluting stent in a 65-year-old man who had experienced acute myocardial infarction and cardiogenic shock consequent to an occluded left main coronary artery. The patient recovered rapidly and completely. We review the medical literature and compare percutaneous coronary intervention with other methods of treatment.
authors.affiliation: Department of Cardiology, Baylor College of Medicine and the Texas Heart Institute at St. Luke's Episcopal Hospital, Houston, Texas 77030, USA.
authors.forename: Mohammed M
authors.initials: MM
authors.lastname: Abuzahra
authors.forename: Andres
authors.initials: A
authors.lastname: Mesa
authors.forename: Bernardo
authors.initials: B
authors.lastname: Treistman
mesh_terms: D000368:Aged; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D020099:Coated Materials, Biocompatible; D017023:Coronary Angiography; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000494:pharmacology*; D008297:Male; D009203:Myocardial Infarction / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D012770:Shock, Cardiogenic / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D020123:Sirolimus / Q000494:pharmacology*; D015607:Stents; D018084:Ultrasonography, Interventional
chemical_list: D020099:Coated Materials, Biocompatible; D007166:Immunosuppressive Agents; D020123:Sirolimus