Emergency surgery after coronary disruption complicating PTCA. Report of four cases.
Four out of 150 patients having a PTCA at our institution sustained a coronary artery disruption and underwent emergency surgery. All of them presented a severe stenosis of the LAD, in 2 of them there was also a stenosis at the origin of a diagonal branch. In each case the injured vessel was a diagonal branch. Three patients had a rupture of subepicardial arteries and developed cardiac tamponade. In another patient the rupture was located intramyocardially. Severe hemodynamic derangement occurred in all 4 cases, one resulting in cardiac arrest. The latter was the only patient who died postoperatively, due to neurological damage. Two of the surviving patients sustained a non-transmural myocardial infarction in the area of the injured vessel. However, all 3 survivors recovered easily and are doing well 6 months after surgery.
Gonzalez-Santos
J M
JM
Vallejo
J L
JL
Pineda
T
T
Zuazo
J A
JA
D000800:Angioplasty, Balloon / Q000009:adverse effects*; D002305:Cardiac Tamponade / Q000209:etiology* / Q000601:surgery; D017023:Coronary Angiography; D003331:Coronary Vessels / Q000293:injuries*; D004630:Emergencies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012421:Rupture