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Clinical Medicine Insights: Case Reports

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A Case of Left Main Coronary Artery Disease in an Octogenarian Treated Surgically and Complicated by Myocardial Infarction: Decisions, Techniques, Rescue and Final Outcome

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Publication Date: 10 Apr 2013

Type: Case report

Journal: Clinical Medicine Insights: Case Reports

Citation: Clinical Medicine Insights: Case Reports 2013:6 61-65

doi: 10.4137/CCRep.S11542

Abstract

We report on an octogenarian patient presenting with an acute coronary syndrome due to significant left main coronary artery disease and severe ostial stenosis of the left anterior descending artery disease. Emergent bypass graft performed with “beating heart” consisted of left internal mammary graft to the mid left anterior descending artery with an “over-stent” anastomosis. The immediate post-operative phase was simple, however the patient presented on post-operative day 8 with extensive anterior myocardial infarction and cardiogenic shock. Emergent coronary angiogram showed subocclusive anastomotic stenosis. Percutaneous coronary intervention was performed on left main, proximal left anterior descending, and proximal circumflex arteries. Subsequently, the patient restored a satisfactory hemodynamic condition. A focus on the importance of decision for management of left main disease especially in octogenarian is presented, along with a review of the pertinent literature.


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What Your Colleagues Say About Clinical Medicine Insights: Case Reports
It was a pleasure participating as a reviewer for Clinical Medicine Insights: Case Reports. The online access was smooth and very user-friendly. The navigation process for submission of reviewer comments was  flawless.Overall, a very pleasant process. The case report that I reviewed was a very interesting one, very well written and with many interesting points for readers.
Macaulay Onuigbo (Associate Professor, College of Medicine, Mayo Clinic, Rochester, MN Nephrologist/Transplant, Physician/Hypertension Specialist, Midelfort Clinic, Mayo Health System, Eau Claire, WI, Regional Direct)
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