Excelsior Correspondent
KATRA, Sept 28: A middle age man hailing from Jammu suffering with acute ST Elevation Myocardial Infarction was successfully operated by the doctors at Shri Mata Vaishno Devi Narayana Hospital, Kakrayal.
The patient was presented to Shri Mata VaishnoDevi Narayana Hospital emergency room and on evaluation with ECG, he was found to have Acute Inferior Wall MI. He was taken to cath lab immediately and Coronary Angiography was done which showed proximal Right Coronary artery 100% massive thrombotic occlusion.
Routine Angioplasty was tried and a wire was put into the Right coronary artery. Multiple attempts to open the thrombotic artery using multiple balloons inflations & Manual Aspiration Thrombectomy was tried but to no respite, failed to open the infarct related artery. To salvage and save the heart muscles (myocardium), catheter directed intra coronary thrombolytic drug (ALTEPLASE) was given directly into the distal part of the artery.
The patient was then shifted to Coronary Care Unit for observation. After 24 hours, check CAG done showed recovery/restoration of blood flow into right coronary artery with little chunk of thrombus lying proximally for which stent was placed successfully. The patient got discharged on Day 2 after procedure and is doing well, and is on routine follow up.
Stating further about the case, Dr Sushant Kumar Sharma, DM Cardiology and Senior Interventional Cardiologistat Narayana Hospital said that large thrombus burden can negatively impact the outcomes following Primary Angioplasties such as distal embolization of clot, no flow or slow flow in the Coronary artery, increase in infarct size, stent thrombosis and even death in patient with Acute MI.
“Catheter directed intra coronary thrombolysis can be performed effectively and safely when repeated balloon inflations and Manual Aspiration Thrombectomy (MAT) fails to produce satisfactory coronary reperfusion (blood flow) in STEMI patients with large thrombus burdens,” he asserted.
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