TITLE:
Surgical Management for a Broken Delivery Shaft in Vivo during PCI Following Acute Myocardial Infarction in a Complex LAD Artery Lesion: A Case Report and Literature Review
AUTHORS:
Md. Abir Tazim Chowdhury, Md. Zulfiqur Haider, Sohail Ahmed, S. M. A. Zulker Nine, Md. Kamrul Hasan, Arup Khan, Md. Junayed Imam Bhuiyan, Mohammad Zishan Uddin, Niaz Ahmed
KEYWORDS:
Percutaneous Coronary Intervention (PCI), Acute Myocardial Infarction (AMI), Angioplasty Hardware, Broken Delivery Shaft, Complex Coronary Lesion, Surgical Revascularization
JOURNAL NAME:
World Journal of Cardiovascular Surgery,
Vol.11 No.11,
November
25,
2021
ABSTRACT: Stuck up and fracture of coronary angioplasty hardware are unwonted
complications of percutaneous coronary interventions (PCI) for which surgical
retrieval and management is once in a while required. We present one case of a
59-year-old diabetic, a hypertensive gentleman who attended the emergency room
(ER) with central chest pain for 2 hours. After evaluation of the patient by physical and noninvasive diagnostic tests, he
was diagnosed as a case of acute myocardial infarction (AMI) with stable
hemodynamic. For the aforementioned findings, the patient was treated first
with a thrombolytic agent in ER and then
shifted to Cardiology Department for monitoring and further coronary evaluation by coronary angiography (CAG).
CAG revealed essentially single
vessel disease (SVD) with complex left anterior descending (LAD) artery
lesion, so PCI was attempted but failed with an unfortunate incidence of the
broken delivery shaft and left in vivo.
Immediate decision making and surgical
management for retrieval of lost angioplasty device and correction coronary lesion with revascularization save the patient from grave complication. All the series of events and management
approaches of this very complex coronary artery lesion are discussed in
this article.