J Korean Med Sci.  2001 Aug;16(4):509-511. 10.3346/jkms.2001.16.4.509.

A Case of Successful Primary Coronary Intervention for the Total Occlusion of Left Main Stem with the Aid of Abciximab

• Jeong MH
• Ahn YK
• Park JC
• Ahn BH
• Na KJ
• Kim NH
• Kim KH
• Cho JG
• Park JC
• Kim SH
• Kang JC

• KMID: 648312
• DOI: http://doi.org/10.3346/jkms.2001.16.4.509

Abstract

A 61-yr-old male patient presented with severe chest pain with cardiogenic shock due to an extensive anterolateral myocardial infarction. Two-dimensional echocardiogram showed severe left ventricular systolic dysfunction (ejection fraction=17%). Emergent coronary angiogram obtained immediately after placing temporary pacing electrode revealed total thrombotic occlusion in the left main stem. We performed direct coronary intervention using kissing balloon technique with the aid of Abciximab (ReoPro(R)) infusion. Residual stenosis with thrombus remained even after high pressure balloon dilatations, therefore we placed two stents, one in the ostia of left anterior descending (LAD) and the other in left circumflex artery (LCX). Coronary angiogram after kissing stents showed improved LAD and LCX flows without residual stenosis. Chest pain resolved and blood pressure normalized after coronary intervention. The whole procedure time was 15 min. Follow-up coronary angiogram taken one week later showed patent previous stented arteries, and echocardiography demonstrated 40% of left ventricular ejection fraction. The clinical course for one-year follow-up was uneventful.

Keyword

Coronary Intervention; Coronary Artery; Myocardial Infarction; Thrombosis

MeSH Terms

Antibodies, Monoclonal/*therapeutic use
Coronary Disease/*therapy
Human
Immunoglobulins, Fab/*therapeutic use
Male
Middle Age
Platelet Aggregation Inhibitors/*therapeutic use
*Stents