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Pseudoaneurysm with thrombus and left ventricular inflow obstruction after left circumflex stenting
John H Shao1, Wilbert S Aronow, Andrew Kupersmith
1Department of Medicine, Cardiology Division, New York Medical College, Valhalla, NY 10595, USA.
American Journal of Therapeutics
|March 22, 2008
Summary
A pseudoaneurysm in the atrioventricular groove caused a patient
Area of Science:
- Cardiology
- Cardiac Surgery
Background:
- Coronary artery stenting is a common procedure for treating coronary artery disease.
- Complications, though rare, can occur post-stenting, necessitating prompt diagnosis and management.
Observation:
- A 61-year-old woman presented with hypotension and orthopnea the day after left circumflex coronary artery stenting.
- Transesophageal echocardiography revealed a pseudoaneurysm in the atrioventricular groove compressing the left atrium.
- The pseudoaneurysm caused left ventricular inflow obstruction.
Findings:
- The pseudoaneurysm contained a thrombus, leading to significant cardiac compression.
- Surgical evacuation of the thrombus resolved the patient's symptoms.
- The left circumflex stent remained patent, indicating the complication was unrelated to stent patency.
Implications:
- This case highlights the importance of considering pseudoaneurysm formation as a potential complication after coronary stenting.
- Timely diagnosis via echocardiography and appropriate management, including surgical intervention, are crucial for favorable outcomes.
- Understanding rare complications can improve patient care protocols in interventional cardiology.
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