RESUMO
The fenestration of a coronary artery hematoma is a therapeutic option in case of a life-threatening spontaneous coronary artery dissection, if the conservative treatment is not feasible. Here we present the case of a 34-year-old woman who presented three spontaneous coronary artery dissections, on three different arteries, over a period of twenty-one months. The diagnosis was confirmed by endovascular imaging. During an acute coronary syndrome, emergent percutaneous coronary intervention of the left anterior descending artery was performed, successfully, by a fenestration of the hematoma, using an AngioSculpt® scoring balloon.
Assuntos
Doença das Coronárias/cirurgia , Anomalias dos Vasos Coronários/cirurgia , Hematoma/cirurgia , Doenças Vasculares/congênito , Adulto , Doença das Coronárias/complicações , Anomalias dos Vasos Coronários/complicações , Anomalias dos Vasos Coronários/patologia , Feminino , Hematoma/complicações , Humanos , Recidiva , Índice de Gravidade de Doença , Doenças Vasculares/complicações , Doenças Vasculares/patologia , Doenças Vasculares/cirurgia , Procedimentos Cirúrgicos VascularesRESUMO
Admission in cardiology departments of patients over 80 years old, even nonagenarians, for ST-segment elevation myocardial infarction (STEMI) is not uncommon in 2018. The management of these high risk and polypathological patients, with atypical clinical presentation, is not based on international guidelines or randomized studies, but rather on retrospective studies, expert consensus, and common sense. Each decision has to be individualized to the patient's situation. This review, after a clinical case, aims to guide the clinician in the specific management of these patients, from the symptoms, to reperfusion strategy, and, as fast as possible, hospital discharge.