Survival after acute myocardial infarction associated with total obstruction of left main coronary artery

We present the clinical and angiographic profile of three patients with class I stable angina pectoris. All had strong coronary risk factors, and stress testing was positive in stage one of the Bruce protocol. Coronary angiography revealed total occlusion of the left main coronary artery (LMCA), and aortocoronary bypass surgery was performed. Thus, total LMCA occlusion may be an unexpected angiographic finding in patients with class I angina.

Section: Left Ventricular Angiogram In End-systole (A) and End-diastomentioning

confidence: 44%

Total occlusion of the left main coronary artery in chronic stable angina pectoris

Sudhir

Abraham

Cherian

et al. 1987

“…This fact likely contributes significantly to the survival of these patients. Others have commented on the significance of collateral circulation in patients with total occlusion of the left main coronary artery [9,12,28,33,35,36]. It must be recognized, however, that most coronary collaterals are endocardial in location, and those usually documented by coronary arteriography are predominantly epicardial in location.…”

Section: Discussionmentioning

confidence: 99%

Survival after myocardial infarction caused by acute left main coronary artery occlusion: Case report and review of the literature

Cohen¹,

Ferguson²

1989

We report a 44-year-old white male presenting with an acute anterior myocardial infarction. Cardiac catheterization at 2 weeks postinfarction revealed total occlusion of the left main coronary artery. There was a normal dominant right coronary artery supplying moderate collaterals to the left coronary system. The patient was managed with conservative therapy and was N.Y.H.A. functional class II on followup 2 years later. A review of the literature relative to myocardial infarction caused by acute left main coronary artery occlusion is presented, and unique features of these cases are described.

Progression of left main coronary artery stenosis following left anterior descending coronary artery angioplasty

Shah²,

Mj³

et al. 1987

Although recent clinical experience indicates a high success rate, percutaneous transluminal coronary angioplasty (PTCA) is still associated with serious complications which usually occur during or shortly after the procedure and are principally related to the lesion or segment of vessel being dilated. We report 2 cases of subacute progression within months of left main stenosis following successful, uncomplicated left anterior descending (LAD) coronary PTCA. Identification of left main trunk involvement may mandate earlier follow-up or intervention.