Coronary Thrombosis and Acute Myocardial Infarction in a Child Following Device Closure of Coronary Artery Fistula

Aim:to investigate safety and angiographic efficacy of two-stage revascularization with percutaneous coronary intervention (PCI) with stenting delayed by one day in patients with acute myocardial infarction (MI) and massive coronary thrombosis.Materials and methods.We included in this study 12 patients with massive infarct related coronary artery thrombus which length was greater than thrice the vessel diameter in the presence of TIMI grade II–III blood flow as detected by coronary angiography (CAG). The emergency PCI was not performed, and conservative antithrombotic therapy continued for 24 hours. After this day, CAG was repeated.Results.Repeat CAG in all patients showed thrombus regression which visually appeared as complete lysis in 8, and partial lysis – in 4 patients. Stenting of residual stenosis was performed in 11 patients without complications. In 1 patient residual stenosis was considered insignificant (<50 %) therefore stenting was not performed. No-reflowphenomenon and recurrent MI were not observed.Conclusion.These data suggest that in patients with massive coronary artery thrombosis conservative antithrombotic therapy for 24 hours followed by repeated CAG and, if required, by stenting of residual stenosis, is safe treatment tactics that might reduce the risk of the no-reflow phenomenon.

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Giant coronary artery fistula complicated with coronary artery aneurysm and acute myocardial infarction: a case report

BMC Cardiovascular Disorders ◽

10.1186/s12872-020-01415-2 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Zhuoxuan Yang ◽

Liang Zhang ◽

Jin Gao ◽

Jingang Cui ◽

Jiansong Yuan ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Case Report ◽

Coronary Artery ◽

Coronary Artery Aneurysm ◽

Artery Aneurysm ◽

Coronary Artery Fistula

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Nonocclusive Coronary Thrombosis In Acute Myocardial Infarction

10.1055/s-0038-1653351 ◽

1981 ◽

Author(s):

R J Frink

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Coronary Artery ◽

Acute Phase ◽

Coronary Arteries ◽

Coronary Thrombosis ◽

Histologic Study ◽

Artery Thrombosis ◽

Coronary Artery Thrombosis ◽

Hospital Deaths

TIn depth histologic study was performed on 23 patients who died during the acute phase or within the first three months following acute myocardial infarction. Six died suddenly and unexpectedly out of the hospital, five of these with the acute myocardial infarction unrecognized.The remainder were hospital deaths, five within the first 48 hours, 8 between 2-14 days, and 4 between 14 and 94 days. Five cases showed subendocardial infarction (SI). Four of these occuring out of hospital. The remaining 18 cases were transmural infarctions (TI). Sixteen of 17 hospital deaths exhibited TI.Special emphasis was given to a histologic search for coronary artery thrombosis, particularly nonocclusive thrombosis (NT), and fibrin fragments in the microcirculation. An acute coronary thrombus (ACT) was found in 22 of 23 (96%) cases. The ACT was totally occlusive in 12 of 23 (52%), and NT in 17 of 23 (74%). TI was associated with an acute occlusive thrombus (OT) in 11 of 18 (61%) , and with NT in 12 (67%). All five cases with SI had a NT. Seven (30%) exhibited both an OT and NT located in different coronary arteries. Six of these had TI.Fibrin fragments were located in the microcirculation of the myocardium in 15 of 23 (65%). These were associated with the fresh OT in 8 of 15 (53%) and with a NT in 12 of 15 (80%).Conclude: 1. NT is more common than OT in deaths associated with acute myocardial ’infarction 2. Fibrin fragments are present in the majority of patients with ACT, particularly NT. 3. SI was consistently asscoiated with NT. 4. OT and NT are frequently present in different arteries in the same heart. 5. NT are common in patients with TI.

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