A Case of Successfully Treated Acute Coronary Occlusion due to a Dissection of the Left Main Trunk after Percutaneous Transluminal Coronary Angioplasty for Acute Myocardial Infarction.
10.4326/jjcvs.28.410
- VernacularTitle:急性心筋梗塞に対するＰＴＣＡ中の左冠状動脈主幹部解離による急性冠状動脈閉塞に，緊急冠状動脈バイパス術を施行し救命した１例
- Author:
Hirohisa Goto
;
Yukio Fukaya
;
Kazunori Nishimura
;
Jun Amano
- Publication Type:Journal Article
- Keywords:
PTCA;
PCPS
- From:Japanese Journal of Cardiovascular Surgery
1999;28(6):410-413
- CountryJapan
- Language:Japanese
-
Abstract:
A 69-year-old man in whom two stents had been implanted on segments 6 and 7 was admitted to our hospital with acute myocardial infarction (AMI). Coronary angiography suggested a total occlusion of the left anterior descending (LAD) between two stents. Percutaneous transluminal coronary angioplasty (PTCA) was performed, but it made an acute coronary occlusion due to a dissection of left main trunk (LMT). As cardiogenic shock occurred, he was put on percutaneous cardioplumonary support (PCPS), and a perfusion catheter was introduced to the LAD and a guide wire to the circumflex (Cx). Emergency coronary artery bypass grafting (CABG) was performed on cardioplumonary bypass (CPB). First, an SVG was grafted to the LAD on ventricular fibrillation, and the other SVG was grafted to segment 13 on cardiac arrest after the perfusion catheter and guide wire was removed. This method allowed this operation to be performed with suitable myocardial protection.
