Clinical case of successful left coronary artery stenting in patient with acute myocardial infarction and acute decompensated left-sided heart failure

Abstract

Patients with major coronary artery involvement are a very tough group to treat in terms of emergent revascularization possibility by percutaneous coronary intervention. Concomitant myocardial infarction and pulmonary edema makes the treatment even more complicated and requires proper anesthetic approach. A patient who had underwent a coronary artery bypass graft surgery for a late stage coronary artery disease 5 years before was admitted to the cardiac intensive care unit with myocardial infarction and acute decompensated left-sided heart failure. Considering the life-threatening angina leading to a serious complications (acute pulmonary edema) and the results of the latest coronary angiography, an urgent coronary angiography with the revision of coronary arteries condition and further possible percutaneous coronary intervention due to life-threatening emergency was offered. Mechanical ventilation was started, the patient’s condition stabilized. Left coronary artery trunk stenting, a difficult approach considering the risk for complications, was performed as the second stage intervention, saving patient’s life.