[Cardiac perforation complicated by cardiac tamponade and sealed with metallic coils].
Distal coronary artery perforation with an angioplasty guidewire is a rare complication that may cause cardiac tamponade, myocardial infarction, arrhythmia, and even death. The use of platelet IIb/IIIa glycoprotein receptor inhibitors increases the risk of potentially fatal complications that are difficult to manage. We report a patient on treatment with abciximab who presented coronary perforation in a distal branch of the right coronary artery caused by the coronary guidewire tip, and complicated by acute cardiac tamponade. Blood extravasation to the pericardium was stopped by releasing two metallic coils into the distal vessel, thereby avoiding the need for emergent cardiac surgery.
Servicio de Cardiología, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain. 18461vmc@comb.es
Vicens
V
Martí
Carlos
C
Castaño
Pere
P
Guiteras
Ermengol
E
Vallés
José M
JM
Domínguez de Rozas
Josep M
JM
Augé
D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D021721:Balloon Occlusion; D002305:Cardiac Tamponade / Q000209:etiology*; D017023:Coronary Angiography; D003328:Coronary Thrombosis / Q000628:therapy; D003331:Coronary Vessels / Q000293:injuries*; D004452:Echocardiography; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015607:Stents; D013997:Time Factors