Evaluation of thrombotic left main coronary artery occlusions; old problem, different treatment approaches
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Date
2018-07
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Publisher
Cardiological Society of India
Abstract
Thrombotic left main coronary artery (LMCA) occlusions usually manifest as acute coronary syndrome (ACS) with cardiogenic shock, acute pulmonary edema, cardiac arrest, fatal arrhythmias or sudden cardiac death. There is no clinically predictor for LMCA thrombosis and no consensus regarding the optimal treatment. In the current literature, treatment options include emergency coronary artery bypass grafting (CABG), stent implantation, intracoronary thrombolysis, anticoagulation with heparin or glycoprotein IIb/IIIa inhibitors, thrombus aspiration as reperfusion strategies. Recently, successful results have been reported with low dose, slow infusion tPA for treatment of LMCA thrombus that allowing coronary flow. This regime may be a new treatment idea in only hemodynamically stable patients. Prospective studies and common consensus are needed about the low dose, slow infusion tPA treatment regime and optimal treatment for thrombotic LMCA obstructions.
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Keywords
Left main coronary artery disease, Thrombus, Different treatment approaches
Citation
Akcay Murat. Evaluation of thrombotic left main coronary artery occlusions; old problem, different treatment approaches. Indian Heart Journal. 2018 Jul; 70(4): 573-574