ABSTRACT
A 73-year-old man was admitted for non-ST segment elevation acute myocardial infarction. Coronary angiography suggested intrastent thrombosis as the etiology, but optical coherence tomography revealed a non-expanded stent, which was successfuly crushed and covered with a new stent.
Subject(s)
Acute Coronary Syndrome/etiology , Coronary Thrombosis/complications , Drug-Eluting Stents/adverse effects , Percutaneous Coronary Intervention/adverse effects , Acute Coronary Syndrome/diagnosis , Aged , Coronary Angiography , Coronary Thrombosis/diagnosis , Humans , Male , Prosthesis Failure , Tomography, Optical Coherence/methodsABSTRACT
An 81-year-old woman was referred for primary angioplasty due to a myocardial infarction. Upon her arrival, the patient was in cardiogenic shock. Coronarography revealed a large filling defect within the left main coronary artery. Thromboaspiration was performed, obtaining thrombotic material and tissue of different consistencies. Balloon angioplasty in the left anterior descending and left main arteries was performed, resulting in incomplete reperfusion, leading to irreversible electromechanical dissociation. Analysis of the aspirated material was consistent with thrombus, atheroma, and calcified tissue. Autopsy revealed a heavily calcified mitral valve, and distal embolization of amorphous material in the microvasculature identical to that found in the mitral valve subapparatus.
