Abstract
We report two cases of acute left main coronary artery obstruction. Because they were hemodynamically unstable and in cardiac arrest refractory to conventional resuscitation measures, emergency percutaneous cardiopulmonary support (PCPS) and intra-aortic balloon pump (IABP) were instituted, which successfully resuscitated the patients. Both of them underwent emergency coronary artery bypass grafting. The first patient survived the surgery and eventually discharged. The second patient was unable to be weaned from the support and died 2 days after surgery. One remarkable difference between these two patients was that reperfusion by PTCA was initially successful in the first patient while reperfusion was not achieved in the second patient. Also, catheter manipulation induced an acute obstruction of left main coronary artery in the second patient, which might have caused poor collateral flow to the circumflex area. In conclusion, initial PTCA is an effective and useful strategy for reperfusion following acute left main coronary artery obstruction. PCPS and IABP are powerful resuscitative tools which may stabilize the patient's hemodynamic condition.
