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Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
06:10

Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock

Published on: June 12, 2021

Catastrophic complication of stent perforation in a uremic patient with acute myocardial infarction

Chiu-Yang Lee1, Yung-Zu Tseng

  • 1Division of Cardiovascular Surgery, Department of Surgery, Show-Chwan Memorial Hospital, Changhua, Taiwan, R.O.C. tumorlee0701@hotmail.com

Journal of the Chinese Medical Association : JCMA
|April 18, 2009
PubMed

Insights

Catheter-induced coronary artery dissection during percutaneous coronary intervention (PCI) is rare but serious. This case highlights emergency surgery as a life-saving intervention for severe complications like stent perforation.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Cardiac Surgery

Background:

  • Coronary angiography and percutaneous coronary intervention (PCI) are standard procedures for acute myocardial infarction.
  • Catheter-induced coronary artery dissection is a known, albeit rare, complication.
  • Stent perforation represents a particularly unusual and potentially fatal complication during PCI.

Observation:

  • A 68-year-old woman with uremia underwent primary PCI for acute myocardial infarction.
  • Guide catheter-induced dissection led to stent perforation and severe left coronary orifice laceration.
  • The patient experienced cardiogenic shock and cardiac arrest.

Findings:

  • Emergency coronary artery bypass grafting and aortomy for left coronary orifice repair were successfully performed.
  • The patient had an uneventful postoperative recovery and was discharged 15 days later.
  • This case demonstrates the feasibility of surgical repair for catastrophic PCI complications.

Implications:

  • Careful patient and lesion selection for PCI may reduce the risk of severe complications.
  • Availability of surgical standby may be crucial for managing devastating intraprocedural events.
  • Proactive management strategies can decrease mortality in patients experiencing severe PCI complications.

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