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KMID : 0368120040340060610
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Korean Circulation Journal
2004 Volume.34 No. 6 p.610 ~ p.614
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Stent Graft for a Coronary Arteriovenous Fistula in Acute Myocardial Infarction
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김한균/Kim HG
정명호/김완/박종철/이정수/홍영준/박형욱/임지현/박옥영/김주한/김원/안영근/조정관/박종춘/강정채/Jeong MH/Kim W/Park JC/Lee JS/Hong YJ/Park HW/Lim JH/Park OY/Kim JH/Kim W/Ahn YK/Cho JG/Park JC/Kang JC
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Abstract
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The stent graft has recently been used for the treatment of coronary artery aneurysms, perforations, dissection and arteriovenous fistula. An 81-year-old male presented with chest pain of 2-day duration. A 12-lead electrocardiogram showed atrial fibrillation and ST-T changes over the precordial leads. A diagnostic left coronary angiogram (CAG) revealed critical stenosis in the proximal left anterior descending coronary artery (LAD) and prestenotic dilatation with large coronary arteriovenous fistula draining into the main pulmonary artery. After predilation, a polytetrafluoroethylene (PTFE) covered stent graft (3.0×16 mm JoStent Graft Master®, JoMed, Germany) for fistula and an additional conventional stent for just below the graft stented site of proximal LAD stenosis were implanted successfully. After stenting, no visible large fistula or remaining stenosis was demonstrated on CAG. The stent graft was deployed with a high success rate. The restenosis rate was not higher than expected for bare stents. However, as subacute occlusion may occur more frequently, long-term ticlopidine or clopidogrel treatment should be required.
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KEYWORD
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