Emergency Coronary Stenting for Complete Thrombotic Occlusion of an Unprotected Left Main Coronary Artery in Acute Myocardial Infarction Complicated by Cardiogenic Shock in an Octogenarian Patient

Abstract

This report concerns an 82-year-old white man, who was admitted with cardiogenic shock secondary to an acute anterior myocardial infarction with right bundle branch block requiring an intra-aortic balloon pump for hemodynamic support and mechanical ventilatory support for respiratory distress. An immediate cardiac catheterization with coronary angiography revealed a complete thrombotic occlusion of the left main coronary artery. Prompt stent-supported percutaneous transluminal coronary angioplasty to the occluded left main coronary artery, a critical stenosis of the ostial left anterior descending artery, and the left circumflex coronary artery, allowed for recovery from this life-threatening condition and subsequent discharge from the hospital of this octogenarian patient. It is suggested that in a critical clinical condition with particularly challenging coronary anatomical findings, stent-supported coronary angio plasty can be lifesaving treatment in selected patients with octogenarian status with acute myocardial infarction.