Arow Ziad, Bar Sef Avigdor, Assali Abid, Arnson Yoav
Cardiology Department, Meir Medical Center, Tchernichovsky St 59, Kfar Saba 4418001, Israel.
Sackler Faculty of Medicine, Tel-Aviv University, Kiryat HaUniversita, Ramat Aviv Tel Aviv 6139001, Israel.
Eur Heart J Case Rep. 2024 Feb 20;8(4):ytae100. doi: 10.1093/ehjcr/ytae100. eCollection 2024 Apr.
A retained coronary guidewire following coronary angiography is an extremely rare complication. We present a case of a retained coronary guidewire from a percutaneous coronary intervention done 2 years ago.
An 80-year-old asymptomatic man with a history of ischemic heart disease and moderate aortic stenosis presented to the echocardiography lab for routine follow-up. Transthoracic echocardiography showed Moderate aortic stenosis and a suspected linear echogenic structure in the ascending aorta. trans-esophageal echocardiography was performed to reveal a mobile and linear echogenic structure originating from the sinuses of Valsalva/Sinotubular junction and extending to the ascending aorta. An electrocardiogram gated cardiac computed tomography was performed and showed A linear well-defined structure originating from the ostium of the left main coronary artery and extending to the ascending aorta-a coronary guidewire from an earlier procedure. A second look at the last invasive coronary angiography record demonstrated the same finding. A multidisciplinary heart team discussion was obtained and concluded that the risk of surgical or endovascular intervention outweighed the potential benefit. The patient was discharged home for a close clinical and echocardiographic follow-up.
A retained coronary guidewire is a rare complication that operators should be aware of. Management should be case-specific depending on clinical presentation.
冠状动脉造影后导丝残留是一种极其罕见的并发症。我们报告一例2年前经皮冠状动脉介入治疗后残留冠状动脉导丝的病例。
一名80岁无症状男性，有缺血性心脏病和中度主动脉瓣狭窄病史，前往超声心动图实验室进行常规随访。经胸超声心动图显示中度主动脉瓣狭窄，升主动脉内可疑线性强回声结构。行经食管超声心动图检查，发现一个活动的线性强回声结构，起自主动脉窦/窦管交界处，延伸至升主动脉。进行了心电图门控心脏计算机断层扫描，显示一个边界清晰的线性结构起自左主干冠状动脉开口，延伸至升主动脉——为先前手术遗留的冠状动脉导丝。再次查看上次有创冠状动脉造影记录，结果相同。组织了多学科心脏团队讨论，结论是手术或血管内介入干预的风险大于潜在益处。患者出院回家，进行密切的临床和超声心动图随访。
冠状动脉导丝残留是一种罕见的并发症，操作人员应予以关注。应根据临床表现进行个体化处理。
