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Nakata, Jun; Saku, Keita; Nishikawa, Takuya; Kimura, Tokuhiro; Sangen, Hideto; Asano, Kazuhiro; Kadooka, Kosuke; Hosokawa, Yusuke; Tara, Shuhei; Shimizu, Wataru; Yamamoto, Takeshi; Asai, Kuniya
International Heart Journal, 2023/03/31, Letnik: 64, Številka: 2Journal Article
A 77-year-old female presented with loss of consciousness, blood pressure of 90/60 mmHg, and heart rate of 47 bpm. At admission, highly sensitive Trop-T and lactate were elevated, and an electrocardiogram revealed an infero-posterior ST elevation myocardial infarction. Echocardiography revealed a depressed left ventricular ejection fraction with abnormal wall motion in the infero-posterior region and hyperkinetic apical movement along with severe mitral regurgitation (MR). Coronary angiography showed a hypoplastic right coronary artery, 100% thrombotic occlusion of the dominant left circumflex (LCx) artery, and 75% stenosis in the left anterior descending (LAD) artery. Substantial hemodynamic improvement with the reduction of acute ischemic MR was achieved by the initiation of an Impella 2.5, which is a transvalvular axial flow pump, and successful percutaneous coronary intervention (PCI) was conducted with stents to the LCx. The patient was weaned off the Impella 2.5 in 5 days, received staged PCI to LAD, and was later discharged after completion of the staged PCI to LAD.
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in: SICRIS
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