Open AccessOptical coherence tomography and fractional flow reserve guided treatment of woven coronary artery anomaly presenting as acute myocardial infarction
Author(s) -
Fangfang Wang,
Jiaguang Han,
Lijun Guo
Publication year - 2020
Publication title -
medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.59
H-Index - 148
eISSN - 1536-5964
pISSN - 0025-7974
DOI - 10.1097/md.0000000000019163
Subject(s) - medicine , fractional flow reserve , cardiology , myocardial infarction , optical coherence tomography , coronary artery disease , coronary artery anomaly , anomaly (physics) , radiology , right coronary artery , coronary angiography , physics , condensed matter physics
Rationale: Woven coronary artery is a very rare congenital anomaly which may lead to acute coronary syndrome in previous literatures. At present, there is no consensus on the treatment of this coronary artery abnormality. Patient concerns: A 48-year-old male was admitted to the other hospital because of persistent chest pain. The electrocardiogram showed an ST-segment elevation in the v1-v5 lead and the patient was diagnosed with acute anterior myocardial infarction. Coronary angiography revealed 2 lumens in the proximal segment of the left anterior descending artery. Then the patient was transferred to our hospital for further diagnosis and treatment. Diagnoses: The patient was diagnosed with acute myocardial infarction and woven coronary. Transthoracic echocardiography showed left ventricular anterior wall segmental motor abnormalities. Interventions: Optical coherence tomography (OCT) and fractional flow reserve (FFR) guided percutaneous coronary intervention was performed successfully. Outcomes: During the follow-up period of 4 years, the patient remained asymptomatic and no adverse events. Lessons: Although the significance of blood flow limitation in one of the lumens detected by FFR is unclear, this strategy of OCT and FFR-guided treatment in woven coronary artery combined with acute coronary events still shows its feasibility.