Perioperative rupture of the LIMA graft leading to cardiogenic shock, emergency angiography, and stenting with a polytetrafluoroethylene-covered stent.
Catheter Cardiovasc Interv
; 79(4): 640-3, 2012 Mar 01.
Article
em En
| MEDLINE
| ID: mdl-21542101
ABSTRACT
A 58-year-old man underwent an elective coronary bypass graft for severe four-vessel stenosis. Cardiogenic shock developed just after coronary bypass grafting with a left internal mammary artery (LIMA) to left anterior descending (LAD) artery and superficial venous graft to 1st and 2nd obtuse marginal (OM1/OM2) arteries the posterior descending artery (PDA) was too small to graft. Despite significant inotropes and an intra-aortic balloon pump, the patient deteriorated in intensive care unit with cardiogenic shock and ventricular arrhythmia. Urgent coronary angiography revealed a rupture or torn LIMA graft with extravasation of contrast into the left pleural cavity. There was no distal LIMA to LAD flow probably due to graft thrombosis. Revascularisation was performed on the severe ostial native LAD stenosis with a drug eluting stent. The rupture graft was then stented with a polytetrafluoroethylene-covered stent, which stopped the bleeding, and latter, led to total graft thrombosis. The patient improved significantly and supportive inotropes could be weaned down. At 11 month follow-up, the patient had mild left ventricular dysfunction, widely patent ostial LAD stent and thrombosed LIMA graft.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Politetrafluoretileno
/
Choque Cardiogênico
/
Angioplastia Coronária com Balão
/
Ponte de Artéria Coronária
/
Angiografia Coronária
/
Materiais Revestidos Biocompatíveis
/
Estenose Coronária
/
Stents Farmacológicos
/
Lesões do Sistema Vascular
/
Artéria Torácica Interna
Tipo de estudo:
Etiology_studies
Limite:
Humans
/
Male
/
Middle aged
Idioma:
En
Ano de publicação:
2012
Tipo de documento:
Article