Rupture of coronary artery and cardiac tamponade complicating Wallstent implantation.
A so-far undescribed complication of Wallstent deployment occurred in a 68-yr-old patient with symptomatic coronary artery disease. The patient had coronary angioplasty to the right coronary artery, complicated by a dissection which necessitated stent implantation. After insertion of one Wallstent, further significant distal disease was observed. An attempt to insert a second Wallstent failed due to inability to retract the constraining membrane and deploy the stent. The stent was withdrawn and another Wallstent was inserted through and distally to the first deployed stent. This time it was not only impossible to retract the membrane but also to withdraw the unimplanted stent. Further attempts to withdraw the stent ended in breakage of the stent delivery system, coronary artery rupture, and cardiac tamponade. The patient was successfully resuscitated and an emergency bypass operation was performed. The mechanism of failure of the Wallstent delivery system is discussed, and recommendations for operators are made.
Mendzelevski
B
B
Department of Invasive Cardiology, Royal Brompton Hospital, London, United Kingdom.
Sigwart
U
U
D000368:Aged; D000800:Angioplasty, Balloon / Q000009:adverse effects* / Q000295:instrumentation; D002305:Cardiac Tamponade / Q000209:etiology* / Q000503:physiopathology; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D003331:Coronary Vessels / Q000293:injuries*; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D011859:Radiography; D012421:Rupture / Q000209:etiology / Q000503:physiopathology; D015607:Stents / Q000009:adverse effects*