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Coronary Perforation Complicating Percutaneous Coronary Intervention - A Case Illustration and Review.

Chin Yong A, Wei Chieh JT - ASEAN Heart J (2013)

Bottom Line: Coronary perforation is a potentially fatal complication during percutaneous coronary intervention (PCI).Reports have shown that it occurs in 0.2 to 0.6% of all patients undergoing the procedures. [1-3] Though the frequency of coronary perforation is low, it is a serious and potentially life-threatening situation that warrants prompt recognition and management.Here we illustrate a case of coronary perforation, and review the incidence, causes, clinical sequelae and management of coronary perforation in the current contemporary practice.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology, National Heart Centre Singapore, Singapore, Singapore.

ABSTRACT

Coronary perforation is a potentially fatal complication during percutaneous coronary intervention (PCI). Reports have shown that it occurs in 0.2 to 0.6% of all patients undergoing the procedures. [1-3] Though the frequency of coronary perforation is low, it is a serious and potentially life-threatening situation that warrants prompt recognition and management. Here we illustrate a case of coronary perforation, and review the incidence, causes, clinical sequelae and management of coronary perforation in the current contemporary practice.

No MeSH data available.


Related in: MedlinePlus

Algorithm for the Management of Coronary Artery Perforation.
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Fig3: Algorithm for the Management of Coronary Artery Perforation.

Mentions: The management of coronary perforation remains challenging, involving continuous assessment of the hemodynamic status while carrying out attempt to seal the perforation. Once coronary artery perforation is identified, prompt management is crucial to avoid emergent surgery and devastating sequelae. (Figure 3) Blood flow at the perforated branch can be blocked by prolonged balloon inflation. This can often be promptly carried out at low pressure (1-2 atmosphere) and should last for 5 to 30 minutes to promote hemostasis at the perforated site and may avoid surgery in two third of cases.[20] If myocardial ischemia develops, the plain balloon should be exchanged with the perfusion balloon that enables perfusion to the distal vessel.


Coronary Perforation Complicating Percutaneous Coronary Intervention - A Case Illustration and Review.

Chin Yong A, Wei Chieh JT - ASEAN Heart J (2013)

Algorithm for the Management of Coronary Artery Perforation.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4544476&req=5

Fig3: Algorithm for the Management of Coronary Artery Perforation.
Mentions: The management of coronary perforation remains challenging, involving continuous assessment of the hemodynamic status while carrying out attempt to seal the perforation. Once coronary artery perforation is identified, prompt management is crucial to avoid emergent surgery and devastating sequelae. (Figure 3) Blood flow at the perforated branch can be blocked by prolonged balloon inflation. This can often be promptly carried out at low pressure (1-2 atmosphere) and should last for 5 to 30 minutes to promote hemostasis at the perforated site and may avoid surgery in two third of cases.[20] If myocardial ischemia develops, the plain balloon should be exchanged with the perfusion balloon that enables perfusion to the distal vessel.

Bottom Line: Coronary perforation is a potentially fatal complication during percutaneous coronary intervention (PCI).Reports have shown that it occurs in 0.2 to 0.6% of all patients undergoing the procedures. [1-3] Though the frequency of coronary perforation is low, it is a serious and potentially life-threatening situation that warrants prompt recognition and management.Here we illustrate a case of coronary perforation, and review the incidence, causes, clinical sequelae and management of coronary perforation in the current contemporary practice.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology, National Heart Centre Singapore, Singapore, Singapore.

ABSTRACT

Coronary perforation is a potentially fatal complication during percutaneous coronary intervention (PCI). Reports have shown that it occurs in 0.2 to 0.6% of all patients undergoing the procedures. [1-3] Though the frequency of coronary perforation is low, it is a serious and potentially life-threatening situation that warrants prompt recognition and management. Here we illustrate a case of coronary perforation, and review the incidence, causes, clinical sequelae and management of coronary perforation in the current contemporary practice.

No MeSH data available.


Related in: MedlinePlus