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Surgical management of iatrogenic coronary artery perforations: when percutaneous treatment fails

Carlotta Brega1, Angelo Pisani1, Wael Braham1

  • 1Department of Cardiac Surgery, Hôpital Bichat-Claude-Bernard, 46 rue Huchard, Paris, France.

Indian Journal of Thoracic and Cardiovascular Surgery
|October 16, 2020
PubMed

Insights

Coronary perforation during percutaneous coronary intervention is rare but serious. This case highlights successful surgical management of a complex perforation with complications, emphasizing the need for onsite cardiac surgery support.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Cardiac Surgery

Background:

  • Coronary perforation is a rare but serious complication of percutaneous coronary interventions (PCI).
  • Prompt recognition and management are crucial for favorable outcomes.
  • While often managed percutaneously, surgical intervention may be necessary in complex cases.

Observation:

  • A patient experienced coronary perforation during PCI, leading to a covered stent's extravascular implantation and liver laceration.
  • Initial percutaneous management was complicated, necessitating further intervention.

Findings:

  • The patient was successfully treated with cardiac surgery.
  • This case underscores the potential complications associated with PCI, including device malposition and associated injuries.

Implications:

  • The proximity of an onsite cardiac surgery center is vital for hospitals performing complex PCI.
  • This case highlights the importance of a multidisciplinary approach and immediate access to surgical expertise for managing PCI complications.
  • Ensuring comprehensive care requires seamless collaboration between interventional and surgical teams.

Keywords:
Cath labCoronary complicationCoronary perforation

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