American Journal of Medical Case Reports
ISSN (Print): 2374-2151 ISSN (Online): 2374-216X Website: http://www.sciepub.com/journal/ajmcr Editor-in-chief: Samy, I. McFarlane
Open Access
Journal Browser
Go
American Journal of Medical Case Reports. 2021, 9(4), 232-235
DOI: 10.12691/ajmcr-9-4-7
Open AccessCase Report

Unexpected Coronary Perforation Complicated by Cardiac Tamponade: A Case Report and How to Treat It

Kitigon Vichairuangthum1, 2,

1Division of Cardiology, Department of Medicine, Suranaree University of Technology Hospital, Nakhon Ratchasima, Thailand

2Royal Heart Center, Bangkok, Thailand

Pub. Date: January 27, 2021

Cite this paper:
Kitigon Vichairuangthum. Unexpected Coronary Perforation Complicated by Cardiac Tamponade: A Case Report and How to Treat It. American Journal of Medical Case Reports. 2021; 9(4):232-235. doi: 10.12691/ajmcr-9-4-7

Abstract

Coronary artery perforation is a rare but fatal complication of percutaneous coronary intervention. Cardiac tamponade constitutes the most severe clinical consequence. If not properly and promptly treated, it is burdened by a high mortality rate. This article report the case of an intra-stent coronary perforation after simple revascularization, followed by an immediate impairment of hemodynamic compensation, due to significant pericardial effusion and sub-sequent cardiac tamponade. While prompt surgical intervention may be lifesaving, expertise in the use of stent graft may provide a valuable rescue option for this serious complication. Interventional cardiologists should be able to recognize and know available treatment options of this serious complication.

Keywords:
coronary perforation percutaneous coronary intervention prolong balloon inflation stent graft

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References:

[1]  Gunning MG, Williams IL, Jewitt DE, Sahah AM, Wainwright RJ, Thomas MR. Coronary artery perforation during percutaneous intervention: incidence and outcome. Heart. 2002; 88: 495-498.
 
[2]  Piraino D, Dendramis G, Buccheri D, Paleologo C, Teresi G, Rotolo A, et al. Case report Coronary artery perforation: How to treat it?. Cor et Vasa. 2015; 57: e334-340.
 
[3]  Ajluni S, Glazier S, Blankenship L, O’Neill WW, Safian RD. Perforation after percutaneous coronary interventions: clinical, angiographic and therapeutic observations. Cathet Cardio Vasc Diagn. 1994; 32: 206-212.
 
[4]  Eric E, Rodney D P. Coronary Perforation An Inconvenient Complication. JACC: Cardiovascular Intervention. 2011; 4: 96-97.
 
[5]  Apró D, Fogarassy G, Posgay B. Case report: Unexpected Coronary Perforation During "Simple" Direct Stenting. Austrian Journal of Cardiology. 2013; 20(7-8): 218-221.
 
[6]  Ellis SG, Ajluni S, Arnold AZ, Popma JJ, Bittl JA, Eigler NL, et al. Increased coronary perforation in the new device era. Incidence, classification, management and outcome. Circulation. 1994: 2725-2730.
 
[7]  Kilic ID, Alihanoglu YI, Yildiz SB, Taskoylu O, Zungur M, Uyar IS, et al. Case report: Coronary artery perforations: Four different cases and a review. Portuguese Journal of Cardiology. 2013; 32(10): 811-815.
 
[8]  Witzke CF, Martin-Herrero F, Clarke SC, Pomerantzev E, Palacios IF. The changing pattern of coronary perforation during percutaneous coronary intervention in the new device era. J Invasive Cardiol. 2004; 16(6): 257-301.
 
[9]  Briguori C, Di Mario C, De Gregorio J, Sheiban I, Vaghetti M, Colombo A. Administration of protamine after coronary stent deployment. Am Heart J. 1999; 138(1): 64-68.
 
[10]  Lee WC, Hsueh SK, Fang CY, Wu CJ, Hang CL, Fang HY. Clinical outcomes following covered stent for the treatment of coronary artery perforation. J Interv Cardiol. 2016; 29: 569-575.
 
[11]  Lemmert ME, Bommel RJ, Diletti R, Wilschut JM, Jaegere PP, Zijlstra F, et al. Clinical Characteristics and Management of Coronary Artery Perforations: A Single-Center 11-Year Experience and Practical Overview. J Am Heart Assoc. 2017; 6: e007049.
 
[12]  Salari A, Heydarnezhad Z, Gholipur M, Rezaeidanesh M, Moaddab F. Coronary Artery Perforation during Percutaneous Coronary Artery Intervention: A Case Report and Literature Review. Archives of Cardiovascular Imaging. 2017; 5(1): 21-24.
 
[13]  Mehrotra S, Vijayvergiya R. Seal it to Heal it-Management of Side Branch Perforation with Autologous Clotted Blood. Juniper online journal of case studies. 2017; 4(2): 001-004.
 
[14]  Shimony A, Joseph L, Mottillo S, Eisenberg MJ. Coronary artery perforation during percutaneous coronary intervention: A systematic review and meta-analysis. Can J Cardiol 2011; 27: 843-850.