Acute total occlusion of the left main coronary artery treated with percutaneous intervention and simultaneous implantation of intra‐aortic balloon pump

Abstract

Key Clinical MessageElectrocardiographic findings at first medical contact and direct transfer to the catheterization laboratory are important in acute total occlusion of the left main coronary artery. Simultaneous emergency angioplasty and intra‐aortic balloon pump implantation might be beneficial in overcoming the patient's most critical hemodynamic instability.

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

“…The LMCA ST-elevation myocardial infarction has been associated with significant morbidity and mortality [1], due to circulatory failure and malignant tachyarrhythmia [4]. These patients' clinical picture is predominantly catastrophic compared to a more distal coronary artery occlusion, as they usually present with sudden cardiac death or profound cardiogenic shock [5]. On the other hand, the elderly become a negative prognostic factor of AMI survival and tend to be treated less aggressively compared to the young [6].…”

Acute Occlusion of a “Protected” Left Main Coronary Artery Manifesting as an Acute Coronary Syndrome with Heart Failure: How much Protected it is?

“…Notwithstanding the altered physical manifestation, individuals with acute obstruction of the protected LMCA continue to exhibit significant unfavorable cardiac events at a comparable frequency.1 Acute occlusion of the LMCA is responsible for the poor clinical outcome owing to fatal arrhythmias and cardiogenic shock. 2 The existence of concurrent protected LMCA, on the other hand, may affect the clinical presentation and prognosis. According to the current studies, acute LMCA occlusion accounts for 0.8% of all primary coronary interventions (PCIs).…”

“…1 Acute occlusion of the LMCA is responsible for the poor clinical outcome owing to fatal arrhythmias and cardiogenic shock. 2 The existence of concurrent protected LMCA, on the other hand, may affect the clinical presentation and prognosis. According to the current studies, acute LMCA occlusion accounts for 0.8% of all primary coronary interventions (PCIs).…”

Electrocardiographic signs of the left main coronary artery disease in acute coronary syndrome

“…СтЛКА обеспечивает кровоснабжение 75% массы левого желудочка (ЛЖ) у пациентов с "правым" или "сбалансированным" типом кровоснабжения и 100% в случае "левого" типа. В связи с этим тяжёлые поражения СтЛКА приводят к нарушению кровоснабжения большей части миокарда ЛЖ с высоким риском угрожающих жизни событий, связанных с дисфункцией ЛЖ, фатальными аритмиями [1][2][3][4][5].…”

“…СтЛКА как инфаркт-связанная артерия чаще идентифицируется при ИМбпST по сравнению с ИМпST (27% и 7%, соответственно) [3]. Эти данные не отражают истинной частоты острой окклюзии СтЛКА в связи с тем, что многие больные погибают до начала лечения [2].…”