Unsuccessful percutaneous transluminal coronary recanalization in coronary embonism Yoshihiko Saito 1 , Masao Yasuno 1 , Moriharu Ishida 1 , Shigeki Endo 1 , Katsuhiro Suzuki 1 , Masaaki Takahashi 1 1Division of Internal Medicine, Shizuoka Rosai Hospital pp.861-865
Published Date 1984/8/15
DOI https://doi.org/10.11477/mf.1404204502
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A 43 year-old man with mitral stenosis and aortic regurgitation was admitted to our hospital because of progressive anterior chest pain. The electro-cardiogram showed atrial fibrillation and ST-segment elevation in leads II, III, and aVF. Coronary arteriography and percutaneous translumi-nal coronary recanalization (PTCR) were performed 3 hours after the onset of his symptoms. The right coronary artery showed complete obstruction just distral to the acute marginal branch without atheromatous change. Inspite of 500pg nitro-glycerin infusion and urokinase infusion into the right coronary artery at a rate of 24000U/min for 50 minutes, combining with "pocking" technique, recanalization could not be obtained. The restudy 6 weeks after PTCR, revealed complete recanaliza-tion of the right coronary artery, but no significant improvement of left ventricular contraction. These findings strongly suggest that the cause of the coronary occlusion in this case was due to coronary embolism. Much higher dose of urokinase would be required in this case.

Copyright © 1984, Igaku-Shoin Ltd. All rights reserved.


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