scholarly journals Primary Percutaneous Coronary Intervention in the Left Main ST-Elevation Myocardial Infarction and Cardiogenic Shock on Octogenarian Patient with Single Remaining Vessel

2021 ◽  
Vol 9 (B) ◽  
pp. 363-366
Author(s):  
Mochamad Yusuf Alsagaff ◽  
Kandita Arjani ◽  
Yudi Oktaviono ◽  
Sondang Sitorus
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery ◽  
Cardiogenic Shock ◽  
Left Main Coronary Artery ◽  
Coronary Intervention ◽  
St Elevation Myocardial Infarction ◽  
Left Main ◽  
Percutaneous Coronary ◽  
History Of ◽  
St Elevation

The left main coronary artery (LMCA) ST-elevation myocardial infarction has been associated with significant morbidity and mortality. Older age and cardiogenic shock are independent predictors for in-hospital mortality. Here, we report a case of an 89-year-old Javanese man with a history of smoking presented with total LMCA occlusion complicated by cardiogenic shock in an octogenarian that was saved by stenting in thrombolysis in myocardial Infarction Flow III right coronary artery.

The acutely occluded left main coronary artery culprit in cardiogenic shock and initial percutaneous coronary intervention: a substudy of the Manitoba “no option” left main PCI registry

2012 ◽  
Vol 90 (9) ◽  
pp. 1325-1331 ◽  
Author(s):  
Farrukh Hussain ◽  
Thang Nguyen ◽  
Nader Elmayergi ◽  
John Ducas ◽  
Kunal Minhas ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Cardiogenic Shock ◽  
Left Main Coronary Artery ◽  
Coronary Intervention ◽  
Ventricular Assist Devices ◽  
Left Main ◽  
Percutaneous Coronary ◽  
The Mean

We aim to describe the in-hospital outcomes of the first reported Canadian cohort of patients with cardiogenic shock and acute myocardial infarction (MI) due to acute and total occlusion of the left main coronary artery, treated with initial percutaneous coronary intervention (PCI). Acute left main thromboses with cardiogenic shock were identified (N = 8) from a retrospective consecutive cohort of high risk left main PCI (N = 56) performed at our institution from 2004–2009. The mean age was 62.3 ± 13.2 years, with 6 (75%) male patients. Successful PCI was performed in all patients, with thrombectomy utilized in 4 patients (50%), stenting in 7 patients (88%), and intra-aortic balloon pump augmentation in 7 patients (88%). Two patients (25%) required extracorporeal membrane oxygenation (ECMO) and 2 other patients required ventricular assist devices. Post-PCI coronary artery bypass grafting (CABG) was performed for 2 patients (25%). The mean SYNTAX score was 26.6 ± 10.5. The mean logistic EuroSCORE was 30.4 ± 12.6%. In-hospital mortality occurred in 3 patients (38%). Acute left main occlusion is a rare but devastating presentation of myocardial infarction, invariably with cardiogenic shock. Emergent PCI may be an effective method to acutely revascularize this subset of patients; however, aggressive post-PCI care including ECMO, CABG, and ventricular support may be required to improve patient survival.

scholarly journals Syncope as initial symptom of ostial lesion of the left main coronary artery with cardiogenic shock

2014 ◽  
Vol 71 (11) ◽  
pp. 1066-1071 ◽  
Author(s):  
Milovan Petrovic ◽  
Igor Ivanov ◽  
Bojan Vujin ◽  
Vladimir Ivanovic ◽  
Aleksandar Redzek
Keyword(s):  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Case Report ◽  
Coronary Artery ◽  
Cardiogenic Shock ◽  
Left Main Coronary Artery ◽  
Coronary Intervention ◽  
Left Main ◽  
Percutaneous Coronary ◽  
Ostial Lesion

Introduction. Syncope represents a relatively atypical symptom of acute coronary syndrome. Syncope itself does not provide enough information to indicate an acute coronary event, especially a lesion of the left main coronary artery, without malignant rhythm and conduction disorders. Case report. A male patient, aged 63, was admitted to the intensive cardiac care unit because of a short loss of consciousness, in sinus tachycardia, with signs of acute heart failure and being hypotensive. Electrocardiogram showed a possible acute anterior myocardial infarction, followed by cardiogenic shock and emergency coronary angiography (subocclusive ostial lesion of the left main coronary artery) and primary percutaneous coronary intervention with intraaortic balloon pump therapy was performed. A direct drug eluting stent was implanted with the optimal primary result. Conclusion. The prompt diagnosis, especially in such relatively atypical clinical presentation, reperfusion therapy with primary percutaneous coronary intervention in acute myocardial infarction complicated by cardiogenic shock, contribute to the improvement in the survival rate and patient's quality of life. This case report is clinically educative due to relatively atypical presentation and performed interventions.

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