Cardiology Research, ISSN 1923-2829 print, 1923-2837 online, Open Access
Article copyright, the authors; Journal compilation copyright, Cardiol Res and Elmer Press Inc
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Case Report

Volume 9, Number 5, October 2018, pages 318-323

Intravascular Ultrasound-Guided Management of Proximal Left Anterior Descending Artery Aneurysm With Covered Stent - A Case Report

Figures

Figure 1.
Figure 1. ECG on admission showing T inversion in lead V3-6, I, aVL with loss of R wave in anterior leads.
Figure 2.
Figure 2. Coronary angiogram in RAO caudal view. OM2 and OM3 has significant lesion. Localized dilatation is noted in proximal LAD.
Figure 3.
Figure 3. Coronary angiogram AP cranial view. Localized dilatation is seen in proximal LAD followed by significant lesion.
Figure 4.
Figure 4. Coronary angiogram LAO caudal view. Short left main artery with localized dilatation in proximal LAD. Left circumflex artery ostium showed no significant lesion.
Figure 5.
Figure 5. Aortic root-shoot in LAO view. The ascending aorta is dilated measuring 5.2 cm.
Figure 6.
Figure 6. Intravascular ultrasound (IVUS) to LAD. Localized dilatation of 7.5 × 6.5 mm was seen in proximal LAD.
Figure 7.
Figure 7. Coronary angiogram in AP cranial view after stenting showing good result with complete exclusion of aneurysm.
Figure 8.
Figure 8. Intravascular ultrasound after implantation of Graftmaster stent in proximal LAD across aneurysm showing adequate apposition of the stent and complete exclusion of aneurysm.
Figure 9.
Figure 9. ECG post procedure showing no fresh changes.

Table

Table 1. Blood Investigations Before and After the Procedure
 
Lab parameterReference rangeBefore procedureAfter procedure
Hemoglobin13 - 17 gm/dL13.4 gm/dL13.1 gm/dL
Total white blood cell count4 × 109 - 11 × 109/L9.2 × 109/L10.2 × 109/L
Platelet count150 × 109 - 400 × 109/L236 × 109/L228 × 109/L
Serum creatinine0.8 - 1.4 mg/dl1.1 mg/dL1.2 mg/dL
Sodium/potassium135 - 145 and 3.5 - 4.9 mmol/L136 and 4.4 mmol/L133 and 4.2 mmol/L
LDL< 3.0 mmol/L3.4 mmol/L