Left Main Coronary Artery Stent Misadventure

Abstract

Coronary artery bypass grafting has long been the standard of care for patients with left main coronary artery (LMCA) disease. Lately, percutaneous coronary intervention (PCI) has become a suitable alternative for these patients, but the procedure may be challenging. We describe 2 cases of LMCA PCI failure requiring surgical intervention. ( Level of Difficulty: Advanced. )

An unexpected image on transesophageal echocardiography: A hyperechogenic ring on the aortic cusp

“…[ 2 ] Stent restenosis, stent rupture, thrombosis, and malpositioning are the most common complications during and after percutaneous interventions for the LMCA. [ 3 ] The treatment approach for a malpositioned stent is still unclear. A malpositioned LMCA stent can be treated either surgically or conservatively.…”

“…Gunes et al[ 4 ] presented a case of a successful removal of a malpositioned right coronary artery stent with a guidewire. Also, in two cases presented by Sechi et al,[ 3 ] malpositioned and thrombosed LMCA stents were surgically treated. Our case was fortunate enough not to have such complications after stent placement.…”