title: Coronary artery perforation by cutting balloon resulting in dissecting subepicardial hematoma and avulsion of the vasculature.
abstract: We report a case of perforation caused by cutting balloon angioplasty of in-stent restenosis in a saphenous vein coronary bypass graft. This was complicated by a subepicardial hematoma leading to avulsion of the penetrating arteries and cardiogenic shock. Despite surgical evacuation and percutaneous left ventricular assist-device support, death ensued.
authors.affiliation: Cardiovascular Division, Brigham and Women's Hospital, Boston, Massachusetts 02115, USA.
authors.forename: Vu H
authors.initials: VH
authors.lastname: Quan
authors.forename: James R
authors.initials: JR
authors.lastname: Stone
authors.forename: Gregory S
authors.initials: GS
authors.lastname: Couper
authors.forename: Campbell
authors.initials: C
authors.lastname: Rogers
mesh_terms: D000368:Aged; D000800:Angioplasty, Balloon / Q000009:adverse effects*; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D023921:Coronary Stenosis / Q000628:therapy*; D003331:Coronary Vessels / Q000293:injuries*; D017809:Fatal Outcome; D006406:Hematoma / Q000209:etiology* / Q000601:surgery; D006801:Humans; D008297:Male