A unique complication of the retrograde approach in angioplasty for chronic total occlusion of the coronary artery.
The retrograde approach for chronic total occlusion of coronary arteries is a new treatment strategy, although its attendant complications have not yet been fully appreciated. We report a case of isolated left ventricular cardiac tamponade caused by guidewire-induced perforation of the septal branch during the retrograde approach, which was subsequently diagnosed by computed tomography (CT) and which required surgical drainage. Guidewire-induced perforation of the septal branch was successfully treated by autologous subcutaneous tissue embolization of the perforated coronary artery. This is the first case of its kind to date.
Matsumi
Jyunya
J
Division of Cardiology and Catheterization Laboratories, Heart Center of ShonanKamakura General Hospital, Yamazaki, Kamakura City, Japan.
Adachi
Koichi
K
Division of Cardiology and Catheterization Laboratories, Heart Center of ShonanKamakura General Hospital, Yamazaki, Kamakura City, Japan.
Saito
Shigeru
S
Division of Cardiology and Catheterization Laboratories, Heart Center of ShonanKamakura General Hospital, Yamazaki, Kamakura City, Japan.
D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods; D002305:Cardiac Tamponade / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D002908:Chronic Disease; D017023:Coronary Angiography; D054059:Coronary Occlusion / Q000000981:diagnostic imaging / Q000628:therapy*; D003331:Coronary Vessels / Q000293:injuries* / Q000473:pathology / Q000601:surgery; D004322:Drainage; D004452:Echocardiography; D004562:Electrocardiography; D006335:Heart Injuries / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D006488:Hemostasis, Surgical; D006801:Humans; D008297:Male; D008875:Middle Aged; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome