Stent graft used to rescue coronary rupture during percutaneous coronary intervention for myocardial bridge

Area of Science:

• Cardiology
• Interventional Cardiology
• Congenital Heart Variations

Background:

• Myocardial bridge (MB) is a congenital anomaly where a segment of a coronary artery tunnels through heart muscle.
• While often asymptomatic, MB can cause symptoms requiring intervention like percutaneous coronary intervention (PCI).
• Coronary artery perforation is a rare but serious complication during PCI.

Observation:

• This case report details a rare instance of coronary artery rupture.
• The rupture occurred during PCI in a patient with a myocardial bridge.
• The affected vessel was the distal segment of the left anterior descending coronary artery (LAD-D).

Findings:

• Percutaneous coronary intervention (PCI) in the presence of a myocardial bridge (MB) can precipitate coronary artery rupture.
• Successful management of LAD-D rupture associated with MB was achieved using a stent graft.
• This highlights a specific complication and its effective resolution.

Implications:

• Stent graft deployment is a viable rescue strategy for coronary artery rupture during PCI in MB patients.
• Awareness of this complication is crucial for interventional cardiologists performing PCI on patients with MB.
• Further research may explore optimal PCI strategies for MB to minimize rupture risk.