Diego Della Riva, Matteo Bruno, Nevio Taglieri
Large clinical trials and meta-analyses have shown that thrombus aspiration (TA) in the setting of ST-T segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI) does not improve clinical outcome, whilst it may be associated with an increased risk of stroke. Accordingly, in the most recent European Society of Cardiology guidelines the role of routine TA during PPCI has been downgraded to a class III recommendation with level A of evidence. On the other hand, it has been suggested that in case of high thrombus burden a selective use of TA may still play a role...
February 2020: Journal of Cardiology Cases
Hidenori Tani, Mitsuaki Sawano, Yohei Numasawa, Yuhei Kobayashi, Masahiro Suzuki, Shigetaka Noma, Yasuyuki Shiraishi, Ikuko Ueda, Keiichi Fukuda, Shun Kohsaka
BACKGROUND: Patients presenting with acute coronary syndrome (ACS) from left main (LM) disease are at a high risk for mortality despite recent advancement in devices and techniques during percutaneous coronary interventions (PCI). We aimed to evaluate patient characteristics, clinical presentations, and key clinical characteristics associated with adverse in-hospital outcomes among ACS patients undergoing LM-PCI. METHODS: We retrospectively identified 280 LM-ACS patients (3...
December 30, 2019: Journal of Cardiology
Daisuke Kaneko, Masao Takahashi, Motoki Fukutomi, Hiroshi Funayama, Kazuomi Kario
We report the case of a 79-year-old man with acute myocardial infarction caused by left main trunk lesion, who experienced cardiogenic shock during percutaneous coronary intervention (PCI). To reverse the cardiogenic shock, we initiated veno-arterial extra corporeal membrane oxygenation (VA-ECMO) without an intra-aortic balloon pump (IABP) due to the severe tortuosity of the left external iliac artery. Although PCI was successful, arterial pressure monitoring revealed that the pulse pressure was too low to recover from the cardiogenic shock of decreased cardiac contraction function (the left ventricular ejection fraction was 30%)...
September 4, 2019: International Heart Journal
Xing Yu, Jian-Yi Zheng, Gui-Ping Zhu
No abstract text is available yet for this article.
July 16, 2019: Journal of International Medical Research
Kei Yamamoto, Kenichi Sakakura, Naoyuki Akashi, Yusuke Watanabe, Masaru Seguchi, Yousuke Taniguchi, Hiroshi Wada, Shin-Ichi Momomura, Hideo Fujita
BACKGROUND: Slow flow can be fatal in primary percutaneous coronary interventions for left main trunk (LMT)-acute myocardial infarction (AMI), however, risk factors for slow flow in LMT-AMI have not been well investigated. Intravascular ultrasound (IVUS) may help to stratify the high-risk lesion for slow flow in LMT-AMI. METHODS: A total of 51 LMT-AMI were included as the study population, and were divided into the slow-flow group (n=22) and the non-slow-flow group (n=29)...
January 2020: Journal of Cardiology
Serge Doucet, E Marc Jolicœur, Patrick W Serruys, Michael Ragosta, Irving L Kron, Werner Scholtz, Jochen Börgermann, Yiran Zhang, Thomas McAndrew, Joseph F Sabik, Arie Pieter Kappetein, Gregg W Stone
BACKGROUND: Prompt revascularization is often required in acute coronary syndromes (ACS), whereas stable ischemic heart disease (SIHD) may allow for more measured procedural planning. Whether the acuity of presentation preferentially affects outcomes after coronary artery bypass grafting (CABG) versus percutaneous coronary intervention (PCI) in patients with left main coronary artery disease (LMCAD) is unknown. We investigated whether the acuity of presentation discriminated patients who derived a differential benefit from PCI versus CABG in the randomized Evaluation of XIENCE versus Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization (EXCEL) trial...
August 2019: American Heart Journal
Yang Gao, Feng Zhang, Chenguang Li, Yuxiang Dai, Ji'e Yang, Ya'nan Qu, Juying Qian, Junbo Ge
BACKGROUND: Primary percutaneous coronary intervention (PCI) for patients presenting with acute myocardial infarction (AMI) caused by left main coronary artery occlusion is associated with significantly higher mortality and risks of major adverse cardiovascular events. Deferred stent implantation may improve prognosis of primary PCI by reducing distal embolization and no-reflow phenomenon. There is no randomized clinical trial focusing on the effect and outcome of deferred stent implantation on primary PCI for left main coronary artery occlusion in contrast with conventional strategy...
March 8, 2019: Trials
Masaki Tsuji, Daisuke Nitta, Shun Minatsuki, Hisataka Maki, Yumiko Hosoya, Eisuke Amiya, Masaru Hatano, Eiki Takimoto, Osamu Kinoshita, Kan Nawata, Minoru Ono, Issei Komuro
Heart transplantation (HTx) is the gold standard therapy to improve quality and quantity of life in end-stage heart failure patients. However, recipients are at risk of experiencing allograft rejection and post-transplant complications, in the acute as well as chronic phase. A 43-year-old man with a history of left ventricular non-compaction underwent orthotopic HTx. On Day 7, transthoracic echocardiography showed a sudden decrease in cardiac function with hypokinesis in a left ventricular anterior wall distribution...
March 10, 2019: ESC Heart Failure
Chen-Yuan Su, Ping-Yen Liu, Po-Wei Chen
No abstract text is available yet for this article.
March 15, 2019: BMJ Case Reports
Nauman Khalid, Lovely Chhabra, Sarah Aftab Ahmad, Pooja Sareen
A 63-year-old woman presented to the emergency department with chest pain. She subsequently underwent an evaluation with a diagnostic coronary angiogram that demonstrated a rare coronary anatomy. Instead of its usual bifurcation into two main branches--a left anterior descending and a left circumflex artery--her left main coronary artery quadfurcated into four branches: a left anterior descending artery, a left circumflex artery, and two ramus intermedii arteries. Possible implications of this unusual finding are discussed...
April 2015: Connecticut Medicine
Ting-Yuan Ni, Fu-Yuan Siao, Chun-Wen Chiu, Hsu-Heng Yen
Refractory ventricular fibrillation with cardiac arrest caused by occlusion of the left main coronary artery may rapidly become fatal. In this report, we describe the case of a 70-year-old male who presented to emergency department with chest pain. Electrocardiogram showed ST-segment elevation in leads aVR and aVL and ST-segment depression in leads v3, v4, v5, v6, 2, 3, and aVF. Occlusion of the left main coronary artery was suspected. While waiting for percutaneous coronary intervention, the patient experienced sudden refractory ventricular fibrillation with cardiac arrest...
March 2019: American Journal of Emergency Medicine
James J Glazier, Amir Kaki, Theodore L Schreiber
We report successful treatment of a patient, who, during diagnostic angiography, developed an ostial left main coronary artery dissection with stump occlusion of the vessel. First, mechanical circulatory support with an Impella CP device was established. Then, patency of the left coronary system was achieved by placement of stents in the left anterior descending, left circumflex, and left main coronary arteries. On completion of the procedure, left ventricular systolic function, as assessed by echocardiography, was normal...
2018: Case Reports in Cardiology
M Zeitouni, O Barthelemy, A Redheuil, P Leprince
A 58 year-old man was admitted in our ICU for cardiogenic shock and electrical storm. His medical history was marked by a triple redo valvular surgery complicated by a recurrent aortic pseudoaneurysm of the ascending aorta. Coronary angiogram and heart CT scan diagnosed an extensive anterior myocardial infarction related to an extrinsic compression of the left main stem by this massive and calcified pseudoaneurysm. Angioplasty or new cardiac surgery options were rejected by the heart team. Despite an unusual indication, the patient was registered on the heart transplant list, and underwent it successfully...
August 24, 2018: Annales de Cardiologie et D'angéiologie
Cinzia D'Angelo, Silvia Zagnoni, Pamela Gallo, Gianfranco Tortorici, Gianni Casella, Giuseppe Di Pasquale
BACKGROUND: Left main trunk (LMT) occlusion is a rare angiographic finding. The primary purpose was to investigate the ECG pattern of patients with angiographic confirmation of LMT as culprit lesion. METHODS: Forty-eight patients (32 men; mean age 73 years) with angiographic total (21 patients; 44%) or subtotal (27 patients; 56%) occlusion of the LMT were analyzed. Twenty patients (42%) were found to have concomitant coronary lesions. Eighteen patients (38%) required intra-aortic balloon pump support...
August 2018: Journal of Cardiovascular Medicine
Mohammady Shahin, Oliver Gaemperli, Patrick Siegrist, Jasmina Alibegovic
Extensive left main (LM) coronary artery thrombus is a rare and life-threatening angiographic finding with usual dramatic clinical presentation including hemodynamic instability and sudden cardiac death. The proper management of a big LM thrombus extending into aorta remains a challenging issue with no clear guidelines. In the following case report we present a 45-year-old patient with no apparent risk factors for coronary artery disease who presented with acute infero-lateral ST-elevation myocardial infarction (STEMI)...
December 2017: Cardiology Research
Vojko Kanic, Damijan Vokac, Samo Granda
Electrocardiographic 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.
December 2017: Clinical Case Reports
Jonathan Yap, Gagan D Singh, Jung-Sun Kim, Krishan Soni, Kelvin Chua, Alvin Neo, Choong Hou Koh, Ehrin J Armstrong, Stephen W Waldo, Kendrick A Shunk, Reginald I Low, Myeong-Ki Hong, Yangsoo Jang, Khung Keong Yeo
INTRODUCTION: Prior studies of ULM STEMI have been confined to small cohorts. Recent registry data with larger patient cohorts have shown contrasting results. We aim to study the outcomes of patients with unprotected left main (ULM) ST-elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (PCI). METHODS: The Asia-pacific left main ST-Elevation Registry (ASTER) is a multicenter retrospective registry involving 4 sites in Singapore, South Korea, and the United States...
April 2018: Journal of Interventional Cardiology
Takayuki Iida, Fumito Tanimura, Kyoko Takahashi, Hideki Nakamura, Satoshi Nakajima, Motoyuki Nakamura, Yoshihiro Morino, Tomonori Itoh
AIM: The aim of this study was to evaluate electrocardiographic characteristics associated with in-hospital prognosis in patients with left main acute coronary syndrome. METHODS AND RESULTS: A total of 89 left main acute coronary syndrome subjects were selected from 3357 consecutive acute coronary syndrome patients (2.7%). Patients of this study were divided into two groups; those who survived and those who died. Patients' characteristics and electrocardiogram on admission were then retrospectively analyzed between the two groups...
April 2018: European Heart Journal. Acute Cardiovascular Care
Takashi Yamauchi, Takafumi Masai, Kenji Fujii, Yoshiki Sawa, Shinya Shirai, Mitsunori Kamigaki, Naofumi Itou
The clinical results of patients with acute myocardial infarction (AMI) at the left main trunk (LMT) remain unclear, especially in cases requiring percutaneous cardiopulmonary support (PCPS). Twenty seven cases of AMI at the LMT requiring emergent PCPS were retrospectively investigated. These 27 patients were aged 44-83 years (65.6 ± 8.6 years) and 20 (81.5%) were men. Peak creatine kinase (CK) leakage ranged from 538 to 34,010 IU/l (13,553 ± 7656 IU/l). Eight (29.6%) patients were discharged without mechanical support...
December 2017: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
Natasha Purai Arora, Mouhammed Joumaa, Howard Rosman, Raj Mehta
Left main coronary artery (LMCA) thrombosis with acute myocardial infarction is a rare condition with very high mortality. The low incidence of this condition and exclusion of patients with LMCA thrombosis from clinical trials prevent the development of optimal management strategy in these patients. Therefore, there are no clear-cut guidelines describing an evidence-based approach for this condition. We describe a patient with LMCA thrombosis presenting with acute myocardial infarction, who was found to have hypercoagulable state related to homocysteinemia on further work-up...
June 2017: American Journal of the Medical Sciences
2017-07-03 06:08:26
Fetch more papers »
Fetching more papers... Fetching...
Remove bar
Read by QxMD icon Read

Save your favorite articles in one place with a free QxMD account.


Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"