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Coronary artery perforation complicated by recurrent cardiac tamponade: a case illustration and review

Michael DePersis1, Safi U Khan1, Edo Kaluski1

  • 1Guthrie Clinic/Robert Packer Hospital, Sayre, PA 18840.

Cardiovascular Revascularization Medicine : Including Molecular Interventions
|March 18, 2017
PubMed

Insights

Coronary artery perforation during percutaneous coronary intervention is a rare, life-threatening complication. This case highlights challenges in managing wire-related perforations, suggesting a need for a structured treatment algorithm.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Vascular Medicine

Background:

  • Coronary artery perforation during percutaneous coronary intervention (PCI) is a rare but severe complication.
  • Potential life-threatening consequences include cardiac tamponade and myocardial infarction, making treatment challenging.

Observation:

  • A 69-year-old female experienced cardiac tamponade due to presumed wire-related perforation of the right coronary artery's posterolateral branch.
  • Her condition was complicated by recurrent tamponade, atrial fibrillation, stress-induced cardiomyopathy, heparin-induced thrombocytopenia, and cardiogenic pulmonary edema.

Findings:

  • The case illustrates the complex clinical course following coronary artery perforation.
  • Management was complicated by multiple comorbidities and iatrogenic issues.

Implications:

  • A systematic treatment algorithm for wire-related coronary perforation is proposed based on medical literature review.
  • This approach aims to guide clinicians in managing this rare but critical complication effectively.

Keywords:
Cardiac tamponadeCoronary artery perforationGuidewire perforation

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