Naslov
Successful primary percutaneous coronary intervention in the first trimester of pregnancy.

Autori
Babić, Zdravko ; Gabrić, Ivo Darko ; Pintarić, Hrvoje

Izvornik
Catheterisation and Cardiovascular Intervention (1522-1946) 77 (2011); 522-525

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, članak, ostalo

Ključne riječi
acute myocardial infarction ; pregnancy ; primary PCI

Sažetak
A 28 yrs. patient, medical nurse, in 10th week of her second pregnancy suffered ventricular fibrillation just after entering the waiting room of The Emergency Department. After she was successfully defibrillated, ECG revealed a large acute anteroseptolateral STEMI. Urgent coronarography was done (premedication with 300 mg of ASA and 600 mg of clopidogrel) with 90 minutes door to balon time. Proximal LAD occlusion was found, primary PCI was done using Amazonia CroCo 3, 0-12 bare-metal STENT and TIMI III flow was achieved. During the procedure the patient was wrapped in lead apron. Because of post resuscitation agitatation procedure was done in i.v. anesthesia. Afterwards revealed risk factors were smoking and hypercholesterolemia. PAI-1 gene 4G/4G genotype and Apo E gene E2/E4 genotype were also found. Estimated X-ray dosage that fetus received during procedure was 0, 45 mSv, what was less than upper safe limit in pregnancy. All drugs given to our patient (clopidogrel, ASA, ivabradine, bisoprolol, anesthetics, LMWH, UH) have B or C FDA Pregnancy Category. Fetal ultrasonography showed normal fetal growth and after consultation with our team, the patient decided to maintain the pregnancy. Before discharge ECHO showed LV of normal size with anteroseptolateral hypokinesia, LVEF of 40-45% and diastolic dysfunction grade II, without pulmonary hypertension. At the 36th week of pregnancy, the patient was hospitalized and closely monitored ; clopidogrel and ASA were discontinued and LMWH has been administered. She gave a birth to a normal boy by vaginal delivery with epidural anesthesia and without any complication.

Izvorni jezik
Engleski

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