Emergency Revascularization Strategies In An Acute Myocardial Infarction Due To The Occlusion Of The Left Main Coronary Artery: A Report Of Three Cases

Abstract

Although acute left main coronary artery (LMCA) occlusion is rare, it carries a very highmortality rate. Several studies have compared the efficacy of elective coronary artery stentingand coronary artery bypass grafting (CABG) in patients with LMCA disease. However, a definitereperfusion modality has yet to be established in ST-elevation myocardial infarction (STEMI)due to acute total occlusion of LMCA, which has catastrophic clinical results. We presentedthree patients with acute anterior STEMI and angiographically documented acute total occlusionof LMCA. All of them were taken to the catheterization laboratory. One patient who was referredto CABG for emergency revascularization died. One died on the 3th day of admission becauseof heart failure.. The other patient, thrombolysis in myocardial infarction (TIMI) III flow wasachieved after percutaneous coronary intervention (PCI), and he was discharged with acceptableshort-term results

Keywords

• Myocardial infarction,cardiogenic shock

Sol Ana Koroner Arter Tıkanıklığına Bağlı Gelişen Akut Miyokard Enfarktüsünde Acil Revaskülarizasyon Stratejileri: 3 Olgu Sunumu

Abstract

Akut sol ana koroner arter tam tıkanması nadir görülmesine rağmen yüksek ölüm riskitaşımaktadır. Birçok çalışmada sol ana koroner arter lezyonu olan hastalarda koroner işlem ilekoroner by-pass’ın etkinliği karşılaştırılmıştır. Sol ana koroner arterin tam tıkanmasına bağlıolarak ölümcül klinik sonuçlara yol açan ST yükselmeli miyokart infarktüsü’nde henüz kesinbir reperfüzyon seçeneği tanımlanmamıştır. Biz burada ST yükselmeli miyokart infarktüsü ilehastanemize başvuran ve yapılan anjiografide sol ana koroner arter akut tam tıkanmasınıngösterildiği üç hasta örneği sunuyoruz. Hastaların tamamı acil olarak kateterizasyonlabaratuvarına alındı. Hastalardan 1’i revaskülarizasyon amacıyla koroner by-pass’agönderilirken öldü. Bir hasta başvurunun üçüncü günü sistolik pompa sebebiyle öldü. Diğer birhastada perkutan koroner işlem sonrası TIMI III akım sağlandı. Takipleri normal seyreden hastataburcu edildi

Keywords

• Miyokart infarktüsü,kardiyojenik şok

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