Defying the Odds: A Young Lady’s Triumph over Complex Coronary Artery Disease

By in Metro MAS Hospital, Jaipur, Rajasthan

In a remarkable case, a 33-year-old woman presented with Coronary Artery Disease (CAD), Acute Coronary Syndrome (ACS), and Non-ST Elevation Myocardial Infarction (NSTEMI). She had a history of CAD, having undergone stenting in the Left Anterior Descending (LAD) artery at an outside hospital a year ago, followed by stenting in the Left Main (LM) coronary artery in the same facility. Unfortunately, she faced the challenge of in-stent restenosis in the LAD stent and underwent angioplasty with a drug-eluting balloon in August 2023.

Further investigations revealed a critical 99% in-stent restenosis in the LM artery and 90% stenosis in the LAD. This presented a grave situation requiring urgent intervention. The medical team had to consider the options of Coronary Artery Bypass Grafting (CABG) or stenting. However, there was a unique challenge: the procedure had to be performed using an Impella LV Assist Device, which comes at a significant cost of around 10-12 lakhs.

The patient sought consultations from renowned hospitals, yet none were willing to proceed without the Impella device. The severity of the lesion was compared to sitting on a ticking time bomb, with the potential to explode anytime, anywhere. In this resource-limited setting, the medical team decided to proceed with Percutaneous Transluminal Coronary Angioplasty (PTCA) for the LM and LAD arteries.

With the grace of God, the procedure went smoothly, and the patient’s condition remained stable throughout. After two days, she was discharged, marking a significant success in her journey. The collaborative efforts of the medical team, combined with the patient’s determination, paved the way for this extraordinary outcome.

This case serves as a testament to the resilience of both the patient and the medical team, who overcame significant challenges in providing the necessary intervention. It emphasizes the importance of making critical decisions in resource-limited settings and finding innovative solutions to ensure optimal patient care.

The successful outcome in this complex scenario reinforces the spirit of hope and underscores the potential for triumph over adversity. The patient’s story serves as an inspiration and a reminder that even in the face of formidable obstacles, determination and perseverance can lead to remarkable
achievements in healthcare.