[Subepicardial hematoma (haemorrhagia per rhexin) after elective PTCA with consecutive compression of the distal RIVA].
A transmural coronary dissection occurred immediately after elective angioplasty of a 90% stenosis of the proximal left anterior descending coronary artery (LAD) within the dilated segment and was followed by subepicardial bleeding (haemorrhagia per rhexin), although no perforation by the guide-wire or the balloon catheter took place. A subepicardial blood bolster led to rapid extravasal compression of the LAD distal from the PTCA site resulting in acute ischemia. None of the conventional rescue-interventions such as stents or autoperfusion catheters were likely to resolve this critical situation and the patient successfully underwent emergency bypass surgery.
Rehders
T C
TC
Abteilung für Kardiologie, Universitätskrankenhauses Hamburg-Eppendorf.
Nienaber
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D000368:Aged; D000784:Aortic Dissection / Q000000981:diagnostic imaging / Q000601:surgery*; D017542:Aneurysm, Ruptured / Q000000981:diagnostic imaging / Q000601:surgery*; D015906:Angioplasty, Balloon, Coronary; D003323:Coronary Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery*; D017023:Coronary Angiography; D003326:Coronary Circulation / Q000502:physiology; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006406:Hematoma / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging / Q000601:surgery*
Subepikardiales Hämatom (Haemorrhagia per rhexin) nach elektiver PTCA mit konskutiver Kompression des distalen RIVA.