This case report demonstrates that spontaneous recanalization of a coronary artery thrombus can occur and may be associated with excellent hemodynamic function despite a large left ventricular scar.
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Spontaneous recanalization may preserve exercise capacity despite scar; leaves open its prevalence and management implications.
Recanalization in a thrombus obstructing the left anterior descending coronary artery was observed in a young man who sustained a transmural myocardial infarction at age 29. An excellent hemodynamic response to exercise stress testing was noted four years after infarction, despite a large left ventricular scar. Analysis of the coronary cineangiograms revealed two discrete vascular channels coursing through an apparent thrombosis at the site of an atherosclerotic segment of the proximal left anterior descending coronary artery.
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Donald A. Spring (1973) studied this question.
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