title: [A rare case of coronary artery perforation by a PTCA guide wire complicating with postinfarction cardiac rupture after thrombolytic therapy].
abstract: We report a rare case of coronary artery perforation by a guide wire for percutaneous transluminal coronary angioplasty (PTCA) complicating with postinfarction cardiac rupture (oozing type). The patient had acute myocardial infarction on the extensive anterior wall and developed cardiac rupture followed by serious cardiac tamponade during the emergency PTCA several hours after tissue plasminogen activator (t-PA) given intravenously. The meandering left anterior descending artery (LAD) was found injured by a PTCA guide wire apart from a small oozing-type cardiac rupture near the apex. We repaired urgently the perforated LAD as well as the ruptured left ventricle. It is thus suggested that coronary artery perforation by a PTCA guide wire may occur on meandering coronary arteries and develop a serious hemorrhagic complication, particularly after thrombolytic therapy.
authors.affiliation: Department of Cardiovascular Surgery, Tenri Hospital, Nara, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Ogino
authors.forename: S
authors.initials: S
authors.lastname: Miki
authors.forename: Y
authors.initials: Y
authors.lastname: Ueda
authors.forename: T
authors.initials: T
authors.lastname: Tahata
authors.forename: K
authors.initials: K
authors.lastname: Morioka
authors.forename: T
authors.initials: T
authors.lastname: Sakai
mesh_terms: D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects* / Q000295:instrumentation; D002305:Cardiac Tamponade / Q000209:etiology / Q000601:surgery; D003331:Coronary Vessels / Q000293:injuries*; D005260:Female; D006342:Heart Rupture, Post-Infarction / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy; D015912:Thrombolytic Therapy / Q000009:adverse effects*; D010959:Tissue Plasminogen Activator / Q000009:adverse effects*
chemical_list: D010959:Tissue Plasminogen Activator