Abstract
A 74-year-old hypertonic patient, diabetic on a diet, with symptomatic ischemic heart disease underwent aortocoronary revascularization with use of three venous grafts (RD, RM II and RIVP) in October 1998. At the same time an inner mammary artery was sewn to r. interventricularis anterior of the left coronary artery (RIA).
In the further course of treatment, angina pectoris relapsed and therefore stents were implanted into RMS I, right coronary artery (at closed bypass on RIVP) and into the distal anastomosis of the venous bypass on RM II. The LIMA on the RIA was functioning well at the moment, and supplied RIA in its entire course, and the native RIA was closed.
On the admission day the patient was woken up by protracted stenocardia with vegetative symptomatology. An ECG showed STEMI of the front and lower wall (Fig. 1).
The patient was taken immediately to the catheter room.