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Long-term treatment effect of a modified jailed-balloon technique for de Winter syndrome: a case report

Ji-Bing Du1, Jia-Jia Wang1,2, Wen-Yu Li1

  • 1Department of Cardiovascular Medicine, Tianjin Cardiovascular Disease Institute, Clinical College of Tianjin Medical University, Tianjin Chest Hospital, Tianjin, People's Republic of China.

The Journal of International Medical Research
|May 5, 2020
PubMed

Insights

Recognizing de Winter syndrome on ECG is crucial for acute anterior myocardial infarction. A modified jailed-balloon technique effectively treated a complex coronary bifurcation lesion, restoring blood flow without side branch loss.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Medical Imaging

Background:

  • De Winter syndrome, an electrocardiographic pattern, signifies acute anterior myocardial infarction requiring prompt intervention.
  • Early identification is critical for initiating reperfusion therapy and improving patient outcomes.

Observation:

  • The case presented with characteristic ECG findings: ST-segment depression and loss of R wave progression in anterior leads.
  • Angiography revealed proximal left anterior descending artery occlusion with a significant stenosis in the first diagonal branch (Medina 1.1.1.).

Findings:

  • A modified jailed-balloon technique was successfully employed during percutaneous coronary intervention.
  • This approach protected the side branch during stenting of the bifurcation lesion.
  • Restoration of Thrombolysis In Myocardial Infarction (TIMI) 3 flow was achieved in both the main vessel and the side branch.

Implications:

  • The modified jailed-balloon technique offers a safe and effective strategy for managing complex coronary artery lesions associated with de Winter syndrome.
  • This method preserves side branches, potentially reducing complications and improving long-term prognosis.
  • Highlights the importance of advanced interventional techniques in treating ST-elevation myocardial infarction variants.

Keywords:
De Winter syndromeacute anterior wall infarctionfirst diagonal branchleft anterior descending arterymodified jailed-balloon techniqueocclusionstent

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