Drug-eluting balloon to treat immediate post-coronary artery bypass grafting ST-elevation myocardial infarction: a case report.

Autor:	Shah MU; Joseph Banks Laboratories, University of Lincoln, Beevor St, Lincoln LN6 7DL, UK.; Department of Cardiology and Cardiac Surgery, Hull University Teaching Hospitals, Cottingham, UK., Haider MA; Department of Cardiology and Cardiac Surgery, Hull University Teaching Hospitals, Cottingham, UK., Poudyal K; Department of Cardiology and Cardiac Surgery, Hull University Teaching Hospitals, Cottingham, UK., Loubani M; Department of Cardiology and Cardiac Surgery, Hull University Teaching Hospitals, Cottingham, UK., Naqvi SY; Department of Cardiology and Cardiac Surgery, Hull University Teaching Hospitals, Cottingham, UK.
Jazyk:	angličtina
Zdroj:	European heart journal. Case reports [Eur Heart J Case Rep] 2024 May 15; Vol. 8 (6), pp. ytae245. Date of Electronic Publication: 2024 May 15 (Print Publication: 2024).
DOI:	10.1093/ehjcr/ytae245
Abstrakt:	Background: Coronary artery bypass graft (CABG) surgery represents a major cardiovascular operation and may be associated with post-operative ST-elevation myocardial infarction (STEMI) due to graft failure. This is challenging to diagnose and treat as the implanted grafts may be prone to complications when treated percutaneously with drug-eluting stents. Case Summary: A man in his 60 s underwent CABG and developed new persistent ST elevations of 2 mm in anterior leads with no significant chest pain, although, administered with intravenous opiates post-operatively. Transthoracic echocardiography was non-diagnostic. Invasive angiography performed emergently showed a thrombotic occlusion of the mid-left anterior descending artery at the site of the anastomosis with the left internal mammary artery (LIMA) graft. Intervention via the graft was considered high risk of complications, therefore, native coronary arteries were used to approach the occlusion, which was successfully cleared with a combination balloon angioplasty with a semi-compliant and then a drug-eluting balloon. The LIMA started working again with the resolution of ST elevation and no immediate complications. Discussion: Early post-operative ST elevations in continuous leads should not be ignored as they often may be the only feature of new-onset STEMI. Drug-eluting balloons represent a feasible and possibly safer option than drug-eluting stents to treat these conditions. Competing Interests: Conflict of interest: None declared. (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.)
Databáze:	MEDLINE
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