Coronary Bypass Surgery after Thrombolytic Therapy for Total Occlusion of the Left Main Coronary Artery

HIROSHI HARA; KENICHI KOSUGA; SHIGEAKI AOYAGI; HARUO AKAGAWA; IZUMI YANAGI; HIROSHI SHIMA; SANEATSU OORYOUJI; KOUICHI HISATOMI; TAKEMI KAWARA; MASAYASU YAMASHITA; AKIHIKO KOGA; KIROKU OOISHI; MICHIHIRO KOGA; YASUO OOKITA; KOUJI HIYAMUTA; KEIICHIRO MIZOGUCHI; HIRONORI TOSHIMA

doi:10.2739/kurumemedj.33.113

HIROSHI HARA, KENICHI KOSUGA, SHIGEAKI AOYAGI, HARUO AKAGAWA, IZUMI YANAGI, HIROSHI SHIMA, SANEATSU OORYOUJI, KOUICHI HISATOMI, TAKEMI KAWARA, MASAYASU YAMASHITA, AKIHIKO KOGA, KIROKU OOISHI, MICHIHIRO KOGA, YASUO OOKITA, KOUJI HIYAMUTA, KEIICHIRO MIZOGUCHI, HIRONORI TOSHIMA

Author information

HIROSHI HARA
Departments of Surgery Kurume University School of Medicine
KENICHI KOSUGA
Departments of Surgery Kurume University School of Medicine
SHIGEAKI AOYAGI
Departments of Surgery Kurume University School of Medicine
HARUO AKAGAWA
Departments of Surgery Kurume University School of Medicine
IZUMI YANAGI
Departments of Surgery Kurume University School of Medicine
HIROSHI SHIMA
Departments of Surgery Kurume University School of Medicine
SANEATSU OORYOUJI
Departments of Surgery Kurume University School of Medicine
KOUICHI HISATOMI
Departments of Surgery Kurume University School of Medicine
TAKEMI KAWARA
Departments of Surgery Kurume University School of Medicine
MASAYASU YAMASHITA
Departments of Surgery Kurume University School of Medicine
AKIHIKO KOGA
Departments of Surgery Kurume University School of Medicine
KIROKU OOISHI
Departments of Surgery Kurume University School of Medicine
MICHIHIRO KOGA
Departments of Surgery Kurume University School of Medicine
YASUO OOKITA
Internal Medicine, Kurume University School of Medicine
KOUJI HIYAMUTA
Internal Medicine, Kurume University School of Medicine
KEIICHIRO MIZOGUCHI
Internal Medicine, Kurume University School of Medicine
HIRONORI TOSHIMA
Internal Medicine, Kurume University School of Medicine

Keywords: total occlusion, left main coronary artery, thrombolysis, aorto-coronary bypass, myocardial infarction

JOURNAL FREE ACCESS

1986 Volume 33 Issue 2 Pages 113-116

DOI https://doi.org/10.2739/kurumemedj.33.113

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Abstract

A 73-year-old man with a history of ischemic heart disease was diagnosed with an extensive, acute anterior myocardial infarction. Coronary arteriography demonstrated total occlusion of the left main coronary artery, and the right coronary artery was predominant. Selective intracoronary thrombolysis was initiated immediately with a total dose of 480, 000 IU of urokinase and resulted in recanalization to a 99% diameter stenosis of the LMCA. Emergency coronary artery bypass grafting was performed 7 hours after recanalization. An intra-aortic balloon pump, inserted before the operation, was removed on the 8th day after the operation. The post operative course seemed to be good; but the patient expired from acute renal failure and sepsis, 45 days after the operation.

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