Limits...
Successful percutaneous coronary intervention in a centenarian patient with acute myocardial infarction.

Lee KH, Jeong MH, Chung CY, Kim D, Lee MG, Park KH, Sim DS, Yoon NS, Yoon HJ, Kim KH, Hong YJ, Kim JH, Ahn Y, Cho JG, Park JC, Kang JC - Korean Circ J (2012)

Bottom Line: Despite an increasing prevalence and burden of disease in the elderly, little is known about the management and outcomes of acute coronary syndromes in this group.The LAD lesion was treated with medical therapy only, on account of the age and general condition of the patient.She was discharged after recovering to a good health status, free of chest pain or dyspnea.

View Article: PubMed Central - PubMed

Affiliation: The Heart Research Center of Chonnam National University Hospital, Cardiovascular Research Institute of Chonnam National University, Gwangju, Korea.

ABSTRACT
Despite an increasing prevalence and burden of disease in the elderly, little is known about the management and outcomes of acute coronary syndromes in this group. We report the case of a 101-year-old female patient with a non-ST segment elevation myocardial infarction. Coronary angiography showed a total occlusion of the proximal right coronary artery (RCA), and a significant stenosis in the proximal to mid left anterior descending artery (LAD). Despite a very poor initial clinical status, a percutaneous coronary intervention was successfully performed for the total occlusion in the RCA. The LAD lesion was treated with medical therapy only, on account of the age and general condition of the patient. She was discharged after recovering to a good health status, free of chest pain or dyspnea.

No MeSH data available.


Related in: MedlinePlus

Balloon angioplasty using a 1.5×13 mm balloon was performed in the proximal and mid RCA (A and B). Subsequently, a 2.75×23 mm Bio-engineered R stent (Genous™) was deployed in the proximal RCA (C, arrow head), accompanied by a 2.75×23 mm bare metal stent (Coroflex blue®) in the mid RCA (C, arrow). The final coronary angiography shows a good distal flow, without any residual stenosis (D). RCA: right coronary artery.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC3369970&req=5

Figure 3: Balloon angioplasty using a 1.5×13 mm balloon was performed in the proximal and mid RCA (A and B). Subsequently, a 2.75×23 mm Bio-engineered R stent (Genous™) was deployed in the proximal RCA (C, arrow head), accompanied by a 2.75×23 mm bare metal stent (Coroflex blue®) in the mid RCA (C, arrow). The final coronary angiography shows a good distal flow, without any residual stenosis (D). RCA: right coronary artery.

Mentions: Coronary angiography (CAG) demonstrated total thrombotic occlusion in the proximal right coronary artery (RCA) and significant stenosis in the proximal to mid left anterior descending artery (LAD) (Fig. 2). For the proximal RCA lesion, percutaneous coronary intervention using a 1.5×13 mm balloon was performed, but some residual stenosis remained after the procedure. Then a 2.75×23 mm bio-engineered R stent (Genous™ bio-engineered R stent) was deployed in the proximal RCA, accompanied by a 2.75×23 mm bare metal stent (Coroflex blue®, B. Braun, Berlin, Germany) implantation for the mid RCA. Final CAG showed good distal flow and no residual stenosis in the RCA (Fig. 3). The LAD lesion was left to be treated after intensive medical therapy and stress testing, such as M-SPECT. No reperfusion arrhythmias, such as an accelerated idioventricular rhythm, were developed during PCI. The post-PCI ECG showed less ST-segment depression in leads V 4-6 compared to the pre-PCI ECG (Fig. 4). With the coronary care unit care, the patient's condition stabilized and complaints of chest pain and dyspnea disappeared. A follow-up ECG showed a considerable improvement of left ventricle systolic function, increasing from 49% to 59%. In light of her age and the improvement of her clinical status, our medical team decided to abandon the stress test and continue treatment with medical therapy only. Because of a residual high platelet reactivity of 319 platelet reaction unit (PRU), she was discharged on triple anti-platelet therapy (Aspirin 100 mg, Clopidogrel 75 mg, Cilostazol 200 mg). She is currently under follow up at the outpatient clinic and remains in good condition.


Successful percutaneous coronary intervention in a centenarian patient with acute myocardial infarction.

Lee KH, Jeong MH, Chung CY, Kim D, Lee MG, Park KH, Sim DS, Yoon NS, Yoon HJ, Kim KH, Hong YJ, Kim JH, Ahn Y, Cho JG, Park JC, Kang JC - Korean Circ J (2012)

Balloon angioplasty using a 1.5×13 mm balloon was performed in the proximal and mid RCA (A and B). Subsequently, a 2.75×23 mm Bio-engineered R stent (Genous™) was deployed in the proximal RCA (C, arrow head), accompanied by a 2.75×23 mm bare metal stent (Coroflex blue®) in the mid RCA (C, arrow). The final coronary angiography shows a good distal flow, without any residual stenosis (D). RCA: right coronary artery.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3369970&req=5

Figure 3: Balloon angioplasty using a 1.5×13 mm balloon was performed in the proximal and mid RCA (A and B). Subsequently, a 2.75×23 mm Bio-engineered R stent (Genous™) was deployed in the proximal RCA (C, arrow head), accompanied by a 2.75×23 mm bare metal stent (Coroflex blue®) in the mid RCA (C, arrow). The final coronary angiography shows a good distal flow, without any residual stenosis (D). RCA: right coronary artery.
Mentions: Coronary angiography (CAG) demonstrated total thrombotic occlusion in the proximal right coronary artery (RCA) and significant stenosis in the proximal to mid left anterior descending artery (LAD) (Fig. 2). For the proximal RCA lesion, percutaneous coronary intervention using a 1.5×13 mm balloon was performed, but some residual stenosis remained after the procedure. Then a 2.75×23 mm bio-engineered R stent (Genous™ bio-engineered R stent) was deployed in the proximal RCA, accompanied by a 2.75×23 mm bare metal stent (Coroflex blue®, B. Braun, Berlin, Germany) implantation for the mid RCA. Final CAG showed good distal flow and no residual stenosis in the RCA (Fig. 3). The LAD lesion was left to be treated after intensive medical therapy and stress testing, such as M-SPECT. No reperfusion arrhythmias, such as an accelerated idioventricular rhythm, were developed during PCI. The post-PCI ECG showed less ST-segment depression in leads V 4-6 compared to the pre-PCI ECG (Fig. 4). With the coronary care unit care, the patient's condition stabilized and complaints of chest pain and dyspnea disappeared. A follow-up ECG showed a considerable improvement of left ventricle systolic function, increasing from 49% to 59%. In light of her age and the improvement of her clinical status, our medical team decided to abandon the stress test and continue treatment with medical therapy only. Because of a residual high platelet reactivity of 319 platelet reaction unit (PRU), she was discharged on triple anti-platelet therapy (Aspirin 100 mg, Clopidogrel 75 mg, Cilostazol 200 mg). She is currently under follow up at the outpatient clinic and remains in good condition.

Bottom Line: Despite an increasing prevalence and burden of disease in the elderly, little is known about the management and outcomes of acute coronary syndromes in this group.The LAD lesion was treated with medical therapy only, on account of the age and general condition of the patient.She was discharged after recovering to a good health status, free of chest pain or dyspnea.

View Article: PubMed Central - PubMed

Affiliation: The Heart Research Center of Chonnam National University Hospital, Cardiovascular Research Institute of Chonnam National University, Gwangju, Korea.

ABSTRACT
Despite an increasing prevalence and burden of disease in the elderly, little is known about the management and outcomes of acute coronary syndromes in this group. We report the case of a 101-year-old female patient with a non-ST segment elevation myocardial infarction. Coronary angiography showed a total occlusion of the proximal right coronary artery (RCA), and a significant stenosis in the proximal to mid left anterior descending artery (LAD). Despite a very poor initial clinical status, a percutaneous coronary intervention was successfully performed for the total occlusion in the RCA. The LAD lesion was treated with medical therapy only, on account of the age and general condition of the patient. She was discharged after recovering to a good health status, free of chest pain or dyspnea.

No MeSH data available.


Related in: MedlinePlus