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Survival after acute and complete occlusion of left main stem


Emmert, M Y; Salzberg, S P; Felix, C; Felder, J G; Falk, V (2010). Survival after acute and complete occlusion of left main stem. Asian Cardiovascular & Thoracic Annals, 18(3):315.

Abstract

A 73-year-old man presented with chest pain, elevated troponin levels, and electrocardiographic signs of acute anterior myocardial infarction. Coronary angiography revealed total occlusion of the left main stem (Figure 1AGo) with moderate collateralization from the right coronary artery (Figure 1BGo). An intraaortic balloon pump was inserted prior to induction of anesthesia for emergency coronary bypass grafting. At this point, hemodynamic compromise occurred, and simultaneous induction of anesthesia and mechanical resuscitation were required. After a median sternotomy, internal massage, and institution of cardiopulmonary bypass, beating-heart double-vessel coronary artery bypass was performed. Extracorporeal membrane oxygenation was used as a bridge to recovery. Early postoperative transesophageal echocardiography revealed massive cardiac edema (Figure 1CGo). The patient was successfully weaned from membrane oxygenation 2 days later, and made a good recovery.

A 73-year-old man presented with chest pain, elevated troponin levels, and electrocardiographic signs of acute anterior myocardial infarction. Coronary angiography revealed total occlusion of the left main stem (Figure 1AGo) with moderate collateralization from the right coronary artery (Figure 1BGo). An intraaortic balloon pump was inserted prior to induction of anesthesia for emergency coronary bypass grafting. At this point, hemodynamic compromise occurred, and simultaneous induction of anesthesia and mechanical resuscitation were required. After a median sternotomy, internal massage, and institution of cardiopulmonary bypass, beating-heart double-vessel coronary artery bypass was performed. Extracorporeal membrane oxygenation was used as a bridge to recovery. Early postoperative transesophageal echocardiography revealed massive cardiac edema (Figure 1CGo). The patient was successfully weaned from membrane oxygenation 2 days later, and made a good recovery.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Cardiovascular Surgery
04 Faculty of Medicine > University Hospital Zurich > Institute of Anesthesiology
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:June 2010
Deposited On:06 Jul 2010 15:05
Last Modified:05 Apr 2016 14:00
Publisher:Sage Publications
ISSN:0218-4923
Publisher DOI:10.1177/0218492310368438
PubMed ID:20519308
Permanent URL: http://doi.org/10.5167/uzh-32132

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