Primary Percutaneous Coronary Intervention in the Left Main ST-Elevation Myocardial Infarction and Cardiogenic Shock on Octogenarian Patient with Single Remaining Vessel

Abstract

The left main coronary artery (LMCA) ST-elevation myocardial infarction has been associated with significant morbidity and mortality. Older age and cardiogenic shock are independent predictors for in-hospital mortality. Here, we report a case of an 89-year-old Javanese man with a history of smoking presented with total LMCA occlusion complicated by cardiogenic shock in an octogenarian that was saved by stenting in thrombolysis in myocardial Infarction Flow III right coronary artery. Edited by: Igor Spiroski Citation: Alsagaff MY, Arjani K, Oktaviono YH, Sitorus SJ. Primary Percutaneous Coronary Intervention in the Left Main ST-Elevation Myocardial Infarction and Cardiogenic Shock on Octogenarian Patient with Single Remaining Vessel. Open Access Maced J Med Sci. 2021 Apr 28; 9(B):363-366. https://doi.org/10.3889/oamjms.2021.6032 Keyword: ST-elevation myocardial Infarction augmented vector right; Left main ST-elevation myocardial Infarction; Single remaining vessel; Octogenarian *Correspondence: Mochamad Yusuf Alsagaff, Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia. E-mail: [email protected] Received: 17-Mar-2021 Revised: 06-Apr-202 Accepted: 18-Apr-2020 Copyright: © 2021 Mochamad Yusuf Alsagaff, Kandita Arjani, Yudi Her Oktaviono, Sondang Jasmine Sitorus Funding: This research did not receive any financial support Competing Interest: The authors have declared that no competing interest exists Open Access: This is an open-access article distributed under the terms of the Creative Commons AttributionNonCommercial 4.0 International License (CC BY-NC 4.0) Introduction The left main coronary artery (LMCA) ST-elevation myocardial infarction has been associated with significant morbidity and mortality . The LMCA culprit lesions in acute coronary syndrome usually present with hemodynamic instability and cardiogenic shock [1]. Older age and cardiogenic shock are independent predictors for in-hospital mortality [2]. Octogenarian people with acute myocardial infarction (AMI) mostly get conservative strategy, although guideline may proceed to myocardial revascularization [3]. Here, we report a case of total LMCA occlusion complicated by cardiogenic shock in an octogenarian that was saved by stenting in thrombolysis in myocardial infarction Flow III right coronary artery (RCA). This case highlights a rare case of STEMI in a single remaining vessel.