Surgical intervention for coronary artery perforation of combined type III and IV due to angioplasty and stent implantation—a case report

Abstract

With ever increasing percutaneous coronary interventions (PCI) for coronary artery disease, the need for emergency coronary artery bypass as a rescue procedure for rare complication is also emerging. Complications following coronary interventions are rare today with an incidence of 0.1 % for lesions treated by balloon angiop las ty and 0.5–3.0 % for les ions t rea ted by atheroablative devices [3, 4]. Complications include hemopericardium, cardiac tamponade, fistula to the left or right ventricle, and coronary arteriovenous fistula. Coronary perforations are associated with high incidence of death, myocardial infarction, and emergency surgery. Only one case of coronary artery rupture both into pericardium and ventricle simultaneously has been reported in the literature. We describe a case of right coronary artery (RCA) perforation after percutaneous transluminal angioplasty and stent implantation, leading to both cardiac tamponade and a fistula to the right ventricle (RV) that was managed with a successful emergency coronary artery bypass grafting (CABG). Case report