title: Percutaneous coronary intervention for three vessels of chronic total occlusion complicated with huge left ventricular thrombus.
abstract: A 55-year-old woman with symptoms of heart failure appeared to have ischemic cardiomyopathy complicated with 3-vessel chronic total occlusion (CTO), severely deteriorated left ventricular (LV) function, and large LV thrombus. Because of high risk of surgical thrombectomy in addition to coronary artery bypass grafting surgery, we first confirmed significant reduction of LV thrombus and performed percutaneous coronary intervention against the 3-vessel CTO under preceding anticoagulation therapy with warfarin, aspirin, and clopidogrel. By means of antegrade/retrograde approach, we successfully implanted everolimus-eluting stents one by one, leading to complete revascularization, dramatically improved LV function, and disappearance of LV thrombus without post-procedural embolism.
authors.affiliation: Department of Cardiology, Kyoto First Red Cross Hospital, Honmachi, Higashiyama-ku, Kyoto, 605-0981, Japan.
authors.forename: Sho
authors.initials: S
authors.lastname: Hashimoto
authors.affiliation: Department of Cardiology, Kyoto First Red Cross Hospital, Honmachi, Higashiyama-ku, Kyoto, 605-0981, Japan. risa11221998@yahoo.co.jp.
authors.forename: Jun
authors.initials: J
authors.lastname: Shiraishi
authors.affiliation: Department of Cardiology, Kyoto First Red Cross Hospital, Honmachi, Higashiyama-ku, Kyoto, 605-0981, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Yanagiuchi
authors.affiliation: Department of Cardiology, Kyoto First Red Cross Hospital, Honmachi, Higashiyama-ku, Kyoto, 605-0981, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Hyogo
authors.affiliation: Department of Cardiology, Kyoto First Red Cross Hospital, Honmachi, Higashiyama-ku, Kyoto, 605-0981, Japan.
authors.forename: Takahisa
authors.initials: T
authors.lastname: Sawada
authors.affiliation: Department of Cardiology, Kyoto First Red Cross Hospital, Honmachi, Higashiyama-ku, Kyoto, 605-0981, Japan.
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Kohno
mesh_terms: D017023:Coronary Angiography; D054059:Coronary Occlusion / Q000175:diagnosis / Q000601:surgery*; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000601:surgery*; D054855:Drug-Eluting Stents / Q000009:adverse effects*; D004452:Echocardiography; D005260:Female; D006331:Heart Diseases / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D006352:Heart Ventricles; D006801:Humans; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects*; D011183:Postoperative Complications; D012086:Reoperation; D017131:Thrombectomy / Q000379:methods; D013927:Thrombosis / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery
keywords: Chronic total occlusion; Everolimus-eluting stent; Ischemic cardiomyopathy; Left ventricular thrombus; Percutaneous coronary intervention