open access

Vol 64, No 7 (2006)
Other
Published online: 2006-07-18
Submitted: 2012-12-28
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Angiogram of the month
Complex percutaneous coronary intervention of left main coronary artery in patient with acute myocardial infarction complicated with cardiogenic shock

Sławomir Dobrzycki, Przemysław Prokopczuk, Karol Kamiński
Kardiol Pol 2006;64(7):754-756.

open access

Vol 64, No 7 (2006)
Other
Published online: 2006-07-18
Submitted: 2012-12-28

Abstract

A case report of succesful complex primary percutaneous coronary intervention (PCI) of left main coronary artery (LMCA) in 75-years old patient with anterolateral acute myocardial infarction is presented. At admission patient was found in cardiogenic shock, with arterial blood pressure 85/60. Echocardiography revealed diffuse LV contraction disorders with ejection fraction 25% as well as echocardiographicaly significant mitral regurgitation. Urgent coronarography showed tight stenosis of distal LMCA with obvious thrombus and significant lesions in ostium of left anterior descendent (LAD) and circumflex artery (CX). Due to high risk of coronary artery bypass graft operation patient was qualified for urgent PCI. After insertion of intraaortic counterpulsation (IABP) and initiation of abxicimab infusion, complex PCI of LMCA, LAD and CX was performed. Coronary stent was implanted to LCA, covering also ostial and proximal LAD, than baloon inflation was performed in ostium of CX. At the end of procedure simultaneous inflation in LMCA/LAD and CX was performed (kissing technique). Patient’s status after PCI stayed stable, on 11. day of hospitalisation patient was discharged.

Abstract

A case report of succesful complex primary percutaneous coronary intervention (PCI) of left main coronary artery (LMCA) in 75-years old patient with anterolateral acute myocardial infarction is presented. At admission patient was found in cardiogenic shock, with arterial blood pressure 85/60. Echocardiography revealed diffuse LV contraction disorders with ejection fraction 25% as well as echocardiographicaly significant mitral regurgitation. Urgent coronarography showed tight stenosis of distal LMCA with obvious thrombus and significant lesions in ostium of left anterior descendent (LAD) and circumflex artery (CX). Due to high risk of coronary artery bypass graft operation patient was qualified for urgent PCI. After insertion of intraaortic counterpulsation (IABP) and initiation of abxicimab infusion, complex PCI of LMCA, LAD and CX was performed. Coronary stent was implanted to LCA, covering also ostial and proximal LAD, than baloon inflation was performed in ostium of CX. At the end of procedure simultaneous inflation in LMCA/LAD and CX was performed (kissing technique). Patient’s status after PCI stayed stable, on 11. day of hospitalisation patient was discharged.
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Keywords

myocardial inforction; left main disease; cardiogenic shock; complex PCI

About this article
Title

Angiogram of the month
Complex percutaneous coronary intervention of left main coronary artery in patient with acute myocardial infarction complicated with cardiogenic shock

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 64, No 7 (2006)

Pages

754-756

Published online

2006-07-18

Bibliographic record

Kardiol Pol 2006;64(7):754-756.

Keywords

myocardial inforction
left main disease
cardiogenic shock
complex PCI

Authors

Sławomir Dobrzycki
Przemysław Prokopczuk
Karol Kamiński

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