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-011
Successful Primary Percutaneous Coronary Intervention for Acute St Elevation Myocardial Infarction in Pregnant Patient
By Anna Francesca Abarquez, Eric Oliver Sison, Lauro Lim Abrahan IV, Elleen Cunanan
Presenter
Anna Francesca Abarquez
Authors
Anna Francesca Abarquez1, Eric Oliver Sison1, Lauro Lim Abrahan IV1, Elleen Cunanan2
Affiliation
Philippine General Hospital, Philippines1, ACE Medical Center Bohol, Philippines2,
View Study Report
TCTAP C-011
CORONARY - Acute Coronary Syndromes (STEMI, NSTE-ACS)
Successful Primary Percutaneous Coronary Intervention for Acute St Elevation Myocardial Infarction in Pregnant Patient
Anna Francesca Abarquez1, Eric Oliver Sison1, Lauro Lim Abrahan IV1, Elleen Cunanan2
Philippine General Hospital, Philippines1, ACE Medical Center Bohol, Philippines2,
Clinical Information
Patient initials or Identifier Number
AFD
Relevant Clinical History and Physical Exam
39-year-old female, non hypertensive, non diabetic, non dyslipidemic, obese gravida 3 para 1 G3P1 (1011) with an unremarkable first trimester of pregnancy, then at her 18th week of pregnancy came in to the emergency department due to chest pain.at ER, vital signs 150/90 mm Hg of blood pressure, a pulse rate of 77 bpm, and a respiratory rate of 18 breaths/min. Oxygen saturation at 97%,no jugular venous distension or carotid bruits,heart sounds were normal,regular. ECG showed anteroseptal STEMI.
Relevant Test Results Prior to Catheterization
Relevant Catheterization Findings
The Left Main Coronary Artery (LMCA) is a large-sized vessel that is free of significant disease. The Left anterior descending artery (LAD) is a large-sized vessel with total occlusion of the proximal segment. The left circumflex artery (LCX) is a large-sized vessel with 30-40% focal stenosis at the proximal segment. The Right Coronary Artery (RCA) is a large-sized vessel that is free of significant disease.
Interventional Management
Procedural Step
JL 4 Fr6 guider was used to cannulate the left circulation. Heparin 5000IU was administered intravenously. Choice PT2 MS 0.014” wire was then inserted through the guider and was advanced until it traversed the proximal LAD lesion. An Emerge 2.5 mm x 12 mm balloon catheter was inserted over the coronary wire until it traversed the LAD lesion. The balloon catheter was then inflated at 10atm (2.65mm) for 15s. The balloon catheter was then pulled out and replaced over-the-wire with a Promus Premier Drug-Eluting Stent 3.0mm x 20mm. It was then positioned at the proximal LAD and deployed at 11atm (2.95mm) x 15s. Post-deployment dilation was performed, maximally inflating the ballon at 15atm(3.14mm). Final shots taken. Catheters pulled out.
Case Summary
Chest pain in a pregnant woman is common and can have many differentials may it be due to cardiovascular and non- cardiovascular causes benign and or life threatening. ST- Elevation Acute myocardial infarction in pregnancy is a rare condition. Acute ST- Elevation Myocardial Infarction, especially in the era of reperfusion, carries a poor prognosis without intervention. Management of acute myocardial infarction whether it be in pregnant or non- pregnant patients should consider both fetal and maternal well- being and a multidisciplinary heart team approach tailored to each patient is advisable for such cases.