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Journal of Case Reports
Left Main Coronary Artery Stenting in an Adolescent: Diagnostic and Therapeutic Challenge
A Kularathne1, TS Sirisena1, HGWAPL Bandara1, G Mayurathan2, T Kogulan1, A Jegavanthan1, NW Kodithuwakku1, WMG Weerakoon1, SR Jayawikcreme1, SNB Dolapihilla1 
1Department of Cardiology, Teaching Hospital Kandy, Sri Lanka; 2District General Hospital, Nuwara-Eliya, Sri Lanka.
Corresponding Author:
Dr. HGWAPL Bandara
Email: lakshmanbandara@gmail.com
Received: 16-JUN-2017 Accepted: 04-DEC-2017 Published Online: 15-NOV-2017
DOI: http://dx.doi.org/10.17659/01.2017.0100
Abstract
Introduction: Coronary artery disease involving the left main stem is an extremely uncommon during adolescent life. Etiologies for such an occurrence may be congenital or acquired, that may be mainly of inflammatory in origin. Case Report: A 14 year old girl presented with acute extensive anterior myocardial infarction and cardiogenic shock. Selective coronary angiography showed isolated near total occlusion of ostial and proximal segments of left main coronary artery with dominant right coronary system, which is free of disease. Emergency Percutaneous Coronary Intervention (PCI) was performed with Evarolimus eluting coronary stent system with re-establishment of left sided coronary blood flow. She showed marked improvement following PCI and was discharged on the 7th day of admission. Conclusion: PCI can be promising intervention for acute total or subtotal occlusion of LMCA even in adolescents, though it is technically challenging.
Keywords : Coronary Angiography, Coronary Artery Disease, Drug-Eluting Stents, Myocardial Infarction.
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