ST Segment myocardial infarction due to totally occluded unprotected left main coronary artery (TOULM): an insight from nationwide database

Abstract Objective This study sought to describe the clinical profile, management and short-term outcomes of patients with ST elevation myocardial infraction (STEMI) due totally occluded unprotected left main coronary artery (TOULM). Methods is a retrospective analysis nationwide STEMI database who underwent primary percutaneous intervention (PPCI). Patients TOULM are defined as having 100% acute thrombotic occlusion or subtotal no more than TIMI 1 flow. Results Between January 2011 February 2022, 7107 Primary Percutaneous Intervention for STEMI. 35 cases (0.5%) all were TOULM. The average age was 51±14 years, predominantly male (94%) had prior cardiac history (94%). 11 (31%) suffered arrest 16 (45%) on mechanical ventilation arrival catheterization laboratory. right dominant vessel in 29 (89%) patients. Right collaterals present 15 (42%), absent 8 (23%) unknown (the injected after not injected) 12 (34%) Mechanical circulatory support used 37% (IABP 8, ECMO 3 plus IABP 2). Revascularization achieved PCI stenting 30 (86%). Five urgent CABG balloon angioplasty. Survival hospital discharge 55%. Conclusions rare occurrence involved mainly history. Despite our series undergoing revascularization, in-hospital mortality almost 50%. One major limitations we post-mortem data any patient died angiography, which potentially will lead higher recorded related mortality. Funding Acknowledgement Type funding sources: None.