Lots of interesting abstracts and cases were submitted for TCTAP 2023. Below are the accepted ones after a thorough review by our official reviewers. Don’t miss the opportunity to expand your knowledge and interact with authors as well as virtual participants by sharing your opinion in the comment section!
TCTAP C-019
Primary Percutaneous Coronary Intervention in a Patient With Single Coronary Artery Ostium Experiencing ST-Elevation Myocardial Infarction
By Ricardo Adrian Nugraha, Bagus Khrisna, Tony Santoso Putra, Lalu Galih Pratama Rinjani, I Gde Rurus Suryawan, Yudi Her Oktaviono
Presenter
Ricardo Adrian Nugraha
Authors
Ricardo Adrian Nugraha1, Bagus Khrisna2, Tony Santoso Putra3, Lalu Galih Pratama Rinjani3, I Gde Rurus Suryawan4, Yudi Her Oktaviono5
Affiliation
Universitas Airlangga - Dr Soetomo General Hospital, Indonesia1, Airlangga University, Indonesia2, Dr. Soetomo General Hospital, Indonesia3, Dr. Soetomo Academic General Hospital, Indonesia4, General Regional Academic Hospital Dr. Soetomo, Universitas Airlangga, Indonesia5,
View Study Report
TCTAP C-019
CORONARY - Acute Coronary Syndromes (STEMI, NSTE-ACS)
Primary Percutaneous Coronary Intervention in a Patient With Single Coronary Artery Ostium Experiencing ST-Elevation Myocardial Infarction
Ricardo Adrian Nugraha1, Bagus Khrisna2, Tony Santoso Putra3, Lalu Galih Pratama Rinjani3, I Gde Rurus Suryawan4, Yudi Her Oktaviono5
Universitas Airlangga - Dr Soetomo General Hospital, Indonesia1, Airlangga University, Indonesia2, Dr. Soetomo General Hospital, Indonesia3, Dr. Soetomo Academic General Hospital, Indonesia4, General Regional Academic Hospital Dr. Soetomo, Universitas Airlangga, Indonesia5,
Clinical Information
Patient initials or Identifier Number
Mr. S
Relevant Clinical History and Physical Exam
A 51 year old male presented to our hospital with history of chest pain for 7 hours. He was a heavy smoker and hypertensive. His family history was unremarkable. At admission, his heart rate was 90 bpm and BP was 130/80 mm Hg. Figure 1: ECG showed ST elevation in lead V1-V4. Figure 2: Transthoracic echocardiography revealed regional wall motion abnormality in anteroseptal basal mid region.
Relevant Test Results Prior to Catheterization
The patient was planned to primary percutaneous coronary intervention. Coronary angiography was performed using the traditional Judkin's method angiography of left coronary artery revealed a normal left main coronary artery (LMCA) which divided into LAD and left circumflex artery (LCx).
Relevant Catheterization Findings
The proximal LAD was giving branch to right coronary artery (RCA), whilst mid portion of LAD was critically stenosis. The thrombus was aspirated and the lesion was crossed with a Whisper MS guide wire. It was predilated with Sapphire II pro balloon and stented with an 2.75 x 24 Angiolite stent with subsequent TIMI 3 flow distally. The patient had an uneventful course after the intervention and was discharged in stable condition after 3 days.
Interventional Management
Procedural Step
- WIRING IS PERFORMED THROUGH THE OCCLUSION TO DISTAL LAD WITH GUIDE WIRE WHISPER MS, SUCCESFUL CROSS THE LESION- PERFORM THROMBUS ASPIRATION WITH 6F THROMBUSTER CAPTURER TO MID LAD- PREDILATATION WAS PERFORMED WITH A 2.5 x 15 mm SAPPHIRE II PRO BALLOON IN THE MID LAD, UNTIL 12 atm/10 seconds- THEN, A 2.75 x 24 mm DES STENT ANGIOLITE (SIROLIMUS) WAS IMPLANTED TO MID LAD, AND EXPANDED TO 10 atm/10 seconds- FINAL ANGIOGRAPHY revealed TIMI flow 3 without other complications during the action, as shown in the movie before.- The patient underwent successful percutaneous coronary intervention in total occlusion of the LAD and was discharged after uneventful recovery.
Case Summary
Although single anomalous origin of coronary artery are quite rare, their clinical significance renders their diagnosis vitally important. Primary PCI should be considered in any patient with stenosis in an anomalous coronary artery in the setting of ST-Elevation Myocardial Infarction, with a few pertinent points must be kept in mind while performing Primary PCI.