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Massive coronary thrombosis caused primary percutaneous coronary intervention to fail in a COVID‐19 patient with ST‐elevation myocardial infarction
Author(s) -
Seif Sherif,
Ayuna Ahmed,
Kumar Abhishek,
Macdonald John
Publication year - 2021
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.29050
Subject(s) - medicine , percutaneous coronary intervention , cardiology , myocardial infarction , coronary thrombosis , thrombosis , covid-19 , disease , infectious disease (medical specialty)
Abstract COVID‐19 is a new viral infection that has a significant impact on global health and economy. Because of its rapid spread worldwide, it may influence the prognosis of other medical conditions, such as ST‐segment elevation myocardial infarction (STEMI). We report a case of a 58‐year female patient admitted with an infero‐posterior STEMI on the background of recently positive COVID‐19 swab. Reperfusion was attempted through primary PCI but unfortunately failed to restore coronary blood flow due to massive thrombotic burden despite several attempts of balloon dilatation and aspiration thrombectomy. She sadly died later on because of hemodynamic deterioration. This scenario raises concerns about Neutrophil Extracellular Traps (NETS) which might potentially have propagated inflammation and thrombosis via platelets' aggregation leading to enhanced coagulopathy and massive coronary thrombosis. Therefore, we suggest primary PCI as the first‐choice of revascularization in patients with combined COVID‐19 and STEMI. Additionally, we emphasize on the importance of using the potent new generation P2Y12 inhibitors along with GPIIb/IIIa inhibitors in every STEMI patient with COVID‐19 to achieve favorable conditions for primary PCI as well as favorable outcomes after stent implantation.