1st Department of Cardiology, Poznań University of Medical Sciences, Poznań, Poland.
Cardiol J. 2009;16(6):568-72.
Although acute left main coronary artery occlusion is rare, it carries a very high mortality rate. Following the encouraging results of trials testing the effect of primary percutaneous coronary intervention, more cases of left main stenosis are treated as culprit lesion in acute myocardial infarction. Few cases of primary percutaneous intervention on left main occlusion have been published. We present the case of an elderly patient presenting with acute myocardial infarction complicated by cardiogenic shock due to left main occlusion, with concomitant chronic total occlusion of right and left anterior descending coronary arteries. Successful percutaneous intervention as a bridge to coronary artery bypass grafting was performed with stent implantation, which resulted in the relief of obstruction, the restoration of blood flow and the immediate clinical improvement of the patient. The patient left the hospital in good condition after 11 days, although she had refused the proposed coronary artery bypass grafting.
尽管急性左主干冠状动脉闭塞较为罕见，但死亡率非常高。随着经皮冠状动脉介入治疗效果试验的结果令人鼓舞，更多的左主干狭窄病例被作为急性心肌梗死的罪犯病变进行治疗。已经发表了一些关于左主干闭塞的经皮介入治疗的病例。我们报告了一例老年患者，因左主干闭塞导致急性心肌梗死合并心源性休克，同时伴有右冠状动脉和左前降支的慢性完全闭塞。成功地进行了经皮介入治疗作为冠状动脉旁路移植术的桥接，支架植入后解除了阻塞，恢复了血流，患者的临床状况立即得到改善。尽管患者拒绝了建议的冠状动脉旁路移植术，但在 11 天后，患者状况良好地出院了。
