The acutely occluded left main coronary artery culprit in cardiogenic shock and initial percutaneous coronary intervention: a substudy of the Manitoba “no option” left main PCI registry

• DOI: 10.1139/y2012-111
• Publication Date: 2012-08-24T09:29:05Z
• Authors: Farrukh Hussain; Thang Nguyen; Nader Elmayergi; John Ducas; Kunal Minhas; Minh Vo; Malek Kass; Amir Ravandi; Gurpreet Parmar; Davinder S. Jassal; James W. Tam; Darren Freed; Alan H. Menkis; Roger K. Philipp
• Keywords: Male; Canada; Coronary Thrombosis; Shock, Cardiogenic; Middle Aged; Severity of Illness Index; 3. Good health; Cohort Studies; Hospitals, University; 03 medical and health sciences; Percutaneous Coronary Intervention; Treatment Outcome; 0302 clinical medicine; Coronary Occlusion; Acute Disease; Humans; Female; Hospital Mortality; Registries; Retrospective Studies

We aim to describe the in-hospital outcomes of first reported Canadian cohort patients with cardiogenic shock and acute myocardial infarction (MI) due total occlusion left main coronary artery, treated initial percutaneous intervention (PCI). Acute thromboses were identified (N = 8) from a retrospective consecutive high risk PCI 56) performed at our institution 2004-2009. The mean age was 62.3 ± 13.2 years, 6 (75%) male patients. Successful in all patients, thrombectomy utilized 4 (50%), stenting 7 (88%), intra-aortic balloon pump augmentation (88%). Two (25%) required extracorporeal membrane oxygenation (ECMO) 2 other ventricular assist devices. Post-PCI artery bypass grafting (CABG) for (25%). SYNTAX score 26.6 10.5. logistic EuroSCORE 30.4 12.6%. In-hospital mortality occurred 3 (38%). is rare but devastating presentation infarction, invariably shock. Emergent may be an effective method acutely revascularize this subset patients; however, aggressive post-PCI care including ECMO, CABG, support improve patient survival.