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Coronary stenting in an elderly patient with an acute myocardial infarction at left main trunk

Keita Sakurai1, Takeshi Suzuki, Ai Nakazawa

  • 1Division of Cardiology, Toyokawa City Hospital, Toyokawa, Japan.

The American Journal of the Medical Sciences
|February 11, 2004
PubMed

Insights

A rare case of acute myocardial infarction (AMI) in the left main trunk (LMT) was successfully treated in an elderly patient. Prompt stenting of the calcified LMT lesion led to a positive outcome and recovery.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Geriatric Cardiology

Background:

  • Acute myocardial infarction (AMI) due to left main trunk (LMT) occlusion is uncommon and carries a poor prognosis, especially in the elderly.
  • Rapid reperfusion is critical for survival in LMT-AMI cases.
  • This report details a unique survival case in a nonagenarian patient.

Observation:

  • A 91-year-old male presented with cardiogenic shock and AMI.
  • Left ventriculography revealed severely reduced ejection fraction (30.8%) with anterolateral and apical akinesis.
  • Coronary angiography identified a critical 90% stenosis at the LMT ostium, confirmed by intravascular ultrasound as circumferential calcification.

Findings:

  • Successful percutaneous coronary intervention (PCI) was performed using stenting to dilate the severely calcified LMT lesion.
  • The patient experienced a favorable recovery, was discharged within a month, and remained asymptomatic at 6-month follow-up.

Implications:

  • This case highlights the feasibility and effectiveness of timely stenting for LMT-AMI, even in elderly patients with extensive calcification.
  • Aggressive revascularization strategies can significantly improve outcomes in high-risk AMI patients.
  • Successful PCI in LMT-AMI can lead to long-term survival and improved quality of life in geriatric populations.

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