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[A surgically treated case of coronary rupture by Palmaz-Schatz stenting]
1Department of Caldiovascular Surgery, Mitsui Memorial Hospital, Tokyo, Japan.
Insights
This case report details a rare coronary artery rupture during Palmaz-Schatz stenting in a 74-year-old woman. Post-balloon dilatation after stenting led to rupture, necessitating emergency coronary artery bypass grafting.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Surgical Innovation
Background:
- Coronary artery stenosis is a significant cardiovascular condition requiring intervention.
- Percutaneous coronary intervention (PCI) and stenting are common treatments.
- Rare complications can arise during complex interventional procedures.
Observation:
- A 74-year-old woman presented with left coronary artery stenosis.
- Initial percutaneous transluminal coronary angioplasty (PTCA) and directional coronary atherectomy resulted in coronary dissection.
- Palmaz-Schatz stenting was performed, followed by balloon post-dilatation.
Findings:
- Extravasation of contrast medium indicated coronary rupture post-stenting and dilatation.
- The rupture was suspected to be caused by post-dilatation of the Palmaz-Schatz stents.
- Emergency coronary artery bypass grafting (CABG) using saphenous vein grafts was successfully performed for hemostasis.
Implications:
- This case highlights a rare but serious complication of Palmaz-Schatz stenting.
- Careful consideration of balloon post-dilatation parameters is crucial in complex stenting procedures.
- Successful surgical management (CABG) can be lifesaving in cases of coronary rupture.
Abstract:
We report a very rare case of coronary rupture by Palmatz-Schatz stenting. The reported patient, 74-year-old woman, had the stenosis of the left coronary artery. When she received PTCA, and directional coronary atherectomy for the left coronary artery, coronary dissection was developed. Though the coronary stenting using two Palmza-Schatz stents for the dissection was attempted, extravasation of a contrast medium after post dilatation by a balloon was found. Since reupture of the left coronary artery was strongly suspected, the emergency operation was required. Hemostasis and the coronary artery bypass grafting using two saphenous veins were performed successfully. We thought that post dilatation by balloon caused the coronary rupture.