ACUTE LEFT MAIN CORONARY ARTERY OBSTRUCTION WITH MYOCARDIAL INFARCTION : Reperfusion Strategies, and the Clinical and Angiographic Outcome
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概要
- 論文の詳細を見る
We studied the clinical and angiographic outcomes in 8 patients with acute left main coronary artery obstruction. Intracoronary thrombolysis with 1.2×10^5 units of urokinase was performed in 3 patients during preparation for percutaneous transluminal coronary angioplasty (PTCA), and failed in all 3 cases. In 2 patients, the left main coronary artery was recanalized by intracoronary thrombolysis with 3.6 and 4.8 × 10^5 units of urokinase, respectively. PTCA was attempted either before or after intracoronary thrombolysis in 5 patients and achieved reperfusion in all 5 cases. However, 2 of the 8 patients had persistent high-grade residual stenosis 69% and 89% luminal reduction, respectively. Emergency coronary artery bypass grafting was successfully performed in these 2 patients, and both are currently alive. Although intraaortic balloon counter-pulsation was performed in all 8 patients, 2 died acutely from pump failure in the catheterization laboratory. One patient died later due to congestive heart failure. The factors favoring survival were right coronary artery dominance and a well-developed collateral circulation. Our findings suggest that PTCA is a useful strategy for reperfusion following acute left main coronary artery occlusion. When PTCA cannot achieve sufficient revascularization, emergency coronary artery bypass grafting should be performed. To control pump failure, intraaortic balloon counterpulsation is insufficient in some cases and more aggressive measures may be required.
- 社団法人日本循環器学会の論文
- 1993-08-20
著者
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Hina Kazuyoshi
Cardiovascular Medicine The Sakakibara Heart Institute Of Okayama
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TSUJI TAKAO
The First Depertment of Internal Medicine, Okayama University Medical School
-
Kusachi Shozo
The First Department of Internal Medicine, Okayama University Medical School
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Kusachi Shozo
The First Department Of Internal Medicine
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Hina Kazuyoshi
The First Department Of Internal Medicine Okayama University Medical School
-
Kita Toshimasa
Cardiovascular Center Sakakibara Hospital
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Kondo Jun
First Department Of Internal Medicine Okayama University Medical School
-
Kita Toshimasa
The Sakakibara Heart Institute of Okayama
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Iwasaki Koichiro
Cardiovascular Center Sakakibara Hospital
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IWASAKI KOHICHIRO
The Cardiovascular Center, Sakakibara Hospital
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HlNA KAZUYOSHI
The Cardiovascular Center, Sakakibara Hospital
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NISHIYAMA OSAMU
The Cardiovascular Center, Sakakibara Hospital
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KONDO JUN
The First Department of Internal Medicine, Okayama University Medical School
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KITA TOSHIMASA
The Cardiovascular Center, Sakakibara Hospital
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HATA TAKATO
The Cardiovascular Center, Sakakibara Hospital
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TANIGUCHI GYOU
The Cardiovascular Center, Sakakibara Hospital
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Hata Takato
The Cardiovascular Center Sakakibara Hospital
-
Hirano Kazuhiro
The 1st Department of lnternal Medicine Okayama University Medical School
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Nishiyama Osamu
The Cardiovascular Center Sakakibara Hospital
-
Tsuji Takao
The First Department Of Internal Medicine
-
Nishiyama Osamu
Cardiovascular Center Sakakibara Hospital
-
Taniguchi Gyou
The Cardiovascular Center Sakakibara Hospital
-
Kita Toshimasa
Sakakibara Jyuzen Hospital
-
Iwasaki Kohichiro
Department Of Cardiology Cardiovascular Institute Sakakibara Hospital
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Hina Kazumasa
Cardiovascular Medicine The Sakakibara Heart Institute Of Okayama
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Iwasaki Kohichirou
Department Of Cardiology Cardiovascular Institute Sakakibara Hospital
-
Nisiyama Osamu
The First Department Of Internal Medicine Okayama University Medical School
-
Taguchi Takehito
Department Of Radiological Technology Faculty Of Health Sciences Okayama University School Of Medici
-
KONDO JUN
First Department of Internal Medicine, Okayama University Medical School
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