Srinivas Sunil Kumar, Patra Soumya, Ramalingam Rangaraj, Agrawal Navin, Syed Tanveer, Shankarappa Ravindranath K, Manjunath Cholenahalli Nanjappa
Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences & Research, Bangalore, Karnataka 560069, India.
J Cardiovasc Dis Res. 2013 Dec;4(4):245-7. doi: 10.1016/j.jcdr.2014.01.003. Epub 2014 Feb 18.
Coronary artery perforation is a rare but catastrophic complication of percutaneous coronary intervention (PCI). Grade III coronary perforation and rupture invariably results in pericardial effusion and tamponade requiring urgent pericardiocentesis. Advances in coronary intervention have increased the opportunity to treat coronary artery perforation. We are reporting a case of 55 years old hypertensive female who presented with effort angina. Coronary angiogram revealed significant stenosis in the left anterior descending coronary artery. Post PCI, she had Ellis type III coronary perforation and pericardial tamponade and cardiogenic shock. The patient was resuscitated, pericardiocentesis done, autologous blood transfusion given and covered stent deployed.
冠状动脉穿孔是经皮冠状动脉介入治疗(PCI)罕见但灾难性的并发症。Ⅲ级冠状动脉穿孔和破裂必然导致心包积液和心脏压塞,需要紧急心包穿刺。冠状动脉介入技术的进步增加了治疗冠状动脉穿孔的机会。我们报告一例55岁高血压女性,因劳力性心绞痛就诊。冠状动脉造影显示左前降支冠状动脉严重狭窄。PCI术后,她出现了埃利斯Ⅲ型冠状动脉穿孔、心包压塞和心源性休克。患者经复苏、进行心包穿刺、给予自体输血并植入覆膜支架。