Korean Circ J.  2012 May;42(5):355-359. 10.4070/kcj.2012.42.5.355.

Successful Percutaneous Coronary Intervention in a Centenarian Patient With Acute Myocardial Infarction

• Lee KH
• Jeong MH
• Chung CY
• Kim D
• Lee MG
• Park KH
• Sim DS
• Yoon NS
• Yoon HJ
• Kim KH
• Hong YJ
• Kim JH
• Ahn Y
• Cho JG
• Park JC
• Kang JC

• KMID: 2028767
• DOI: http://doi.org/10.4070/kcj.2012.42.5.355

Abstract

Despite an increasing prevalence and burden of disease in the elderly, little is known about the management and outcomes of acute coronary syndromes in this group. We report the case of a 101-year-old female patient with a non-ST segment elevation myocardial infarction. Coronary angiography showed a total occlusion of the proximal right coronary artery (RCA), and a significant stenosis in the proximal to mid left anterior descending artery (LAD). Despite a very poor initial clinical status, a percutaneous coronary intervention was successfully performed for the total occlusion in the RCA. The LAD lesion was treated with medical therapy only, on account of the age and general condition of the patient. She was discharged after recovering to a good health status, free of chest pain or dyspnea.

Keyword

Centenarian; Myocardial infarction; Percutaneous transluminal coronary angioplasty

MeSH Terms

Acute Coronary Syndrome
Aged
Aged, 80 and over
Angioplasty, Balloon, Coronary
Arteries
Chest Pain
Constriction, Pathologic
Coronary Angiography
Coronary Vessels
Dyspnea
Female
Humans
Myocardial Infarction
Percutaneous Coronary Intervention
Prevalence

Figure

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  Fig. 1 The electrocardiography shows a sinus tachycardia and ST-segment depression in leads V 4-6.

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  Fig. 2 Coronary angiography shows a significant stenosis of the proximal to mid left anterior descending artery (arrowheads) (A and B) and total thrombotic occlusion of the proximal right coronary artery (arrow) (C and D).

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  Fig. 3 Balloon angioplasty using a 1.5×13 mm balloon was performed in the proximal and mid RCA (A and B). Subsequently, a 2.75×23 mm Bio-engineered R stent (Genous™) was deployed in the proximal RCA (C, arrow head), accompanied by a 2.75×23 mm bare metal stent (Coroflex blue®) in the mid RCA (C, arrow). The final coronary angiography shows a good distal flow, without any residual stenosis (D). RCA: right coronary artery.

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  Fig. 4 The post-PCI electrocardiography shows less ST-segment depression in leads V 4-6, compared to pre-PCI. PCI: percutaneous coronary intervention.

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