Infarctus par occlusion aiguë du tronc commun non protégé : à propos de six cas traités par angioplastie |
| |
Authors: | I Ghrissi W Amara P Michaud J-B Estève S Cattan |
| |
Institution: | Fédération de cardiologie, centre hospitalier intercommunal Le-Raincy-Montfermeil, 10, rue Général-Leclerc, 93370 Montfermeil, France |
| |
Abstract: | AimAcute main left coronary artery occlusion is rarely observed during primary angioplasty in myocardial infarction. This retrospective study reports the results of six patients treated by angioplasty in a hospital without cardiac surgery department.Patients and methodsFrom 2002 to 2009, 746 patients were treated by primary angioplasty for acute coronary syndromes with ST elevation. Among those patients, six (0,7%) had acute non protected main left coronary occlusion. We report clinical, angiographical data and follow-up.ResultsThe population was composed of six patients (five males) with an average age of 64 ± 7 years. Five patients were admitted with cardiogenic shock and four were mechanically ventilated. Distal occlusion of main left coronary artery and dominant right coronary artery were noted in all cases. Sub-occluded lesion of right coronary artery was noted in one case. Successful procedure with bare metal stent was achieved in five cases. Mortality rate was 66% (n = 4): three patients died in hospital and another 1 or 2 months later of congestive heart failure. Coronary artery bypass grafting was performed at 4 and 12 months later for two patients. They are alive after 12 and 72 months of follow-up.ConclusionWe demonstrate the feasibility of percutaneous coronary intervention of acute main left coronary occlusion. Inspite successful procedure, intrahospital mortality rate is still high and prognosis is related to cardiogenic shock. |
| |
Keywords: | Occlusion aiguë du tronc commun Infarctus du myocarde Angioplastie Choc cardiogé nique Assistance circulatoire |
本文献已被 ScienceDirect 等数据库收录! |
|