title: Primary Percutaneous Coronary Intervention Followed by Valve Surgery for Acute Coronary Syndrome at Left Main Trunk Complicated With Severe Aortic Stenosis.
abstract: An 89-year-old woman appeared to have acute coronary syndrome at the left main trunk (LMT) complicated with severe aortic stenosis, moderate-severe mitral regurgitation, depressed left ventricular (LV) function, and multivessel disease. Because of sustained hypotension even under intra-aortic balloon pumping support during emergency coronary angiograhy, we performed primary percutaneous coronary intervention solely for the LMT lesion using a bare metal stent, leading to recovery from the shock state. On the second hospital day, based on our heart-team consensus, we performed aortic valve replacement and coronary artery bypass grafting surgery, and added edge-to-edge repair (Alfieri stitch) of the mitral valve, resulting in complete revascularization and dramatically improved LV function.
authors.affiliation: Department of Cardiology, Kyoto First Red Cross Hospital.
authors.forename: Akira
authors.initials: A
authors.lastname: Shikuma
authors.forename: Jun
authors.initials: J
authors.lastname: Shiraishi
authors.forename: Kazunari
authors.initials: K
authors.lastname: Okawa
authors.forename: Masaki
authors.initials: M
authors.lastname: Yashige
authors.forename: Keisuke
authors.initials: K
authors.lastname: Shoji
authors.forename: Daisuke
authors.initials: D
authors.lastname: Ito
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Kimura
authors.forename: Eigo
authors.initials: E
authors.lastname: Kishita
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Nakagawa
authors.forename: Masayuki
authors.initials: M
authors.lastname: Hyogo
authors.forename: Akiyuki
authors.initials: A
authors.lastname: Takahashi
authors.forename: Takahisa
authors.initials: T
authors.lastname: Sawada
mesh_terms: D054058:Acute Coronary Syndrome / Q000150:complications* / Q000601:surgery; D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000150:complications* / Q000601:surgery; D013504:Cardiovascular Surgical Procedures; D001026:Coronary Artery Bypass; D005260:Female; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008944:Mitral Valve Insufficiency / Q000150:complications* / Q000601:surgery; D062645:Percutaneous Coronary Intervention