Left main intervention in myocardial infarction.
We report an 84-year-old patient who suddenly developed nausea, vomiting, hypotension, and needed intubation, assisted ventilation and pharmacological vasopressor support. Admission EKG showed anterior and lateral leads ST segment depression and 2 mm ST segment elevation in avR lead. Angiogram showed unprotected left-main coronary-artery (LM) sub-occlusive disease and totally occluded ostial right-coronary-artery (RCA), distally filled through the left-coronary system. Unprotected LM disease was immediately treated with bare metal stent. The stent jailed the left-circunflex coronary-artery (LCx) ostium but did not compromise the arterial flow. Lately, the patient was discharged in a very good health condition. Ten months angiographic follow-up showed an extremely compromised LCx ostium treated successfully with drug eluted stent (DES) and mid left anterior descendent (LAD) severe lesion, treated with DES.
Castagna
Marco T
MT
Department of Cardiology, Instituto de Cardiologia, Hospital São Francisco, Belo Horizonte, MG, Brazil. marcocastagna@hotmail.com
Machado
Mauricio Cavalieri
MC
de Oliveira
Jordan Vieira
JV
D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D003326:Coronary Circulation; D054855:Drug-Eluting Stents; D004562:Electrocardiography; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D016896:Treatment Outcome