title: Stenting a myocardial bridge: a wrong decision in STEMI?
abstract: In a STEMI setting, stent implantation for a myocardial bridge (MB) with significant systolic compression in the mid LAD, is a challenging issue.The risk of coronary rupture during stent implantation arises from: (i) a thin intima of the bridged artery; (ii) a thin myocardial layer toward the right ventricle; (iii) a smaller LAD diameter in the MB; (iv) high inflation pressure in the balloon. Perforation with a coronary fistula resolving spontaneously within several months is one of the possible scenarios. We report a case of a coronary fistula between mid LAD and right ventricle after MB stenting in a patient with STEMI, with spontaneous angiographic deterioration after several days. Stent graft implantation in case of a coronary fistula with increasing flow is an effective therapeutic concept.
authors: Division of Cardiology, Clinical Centre of Serbia, University of Belgrade, Belgrade, Serbia. mmntom@eunet.rs
authors: Miloje
authors: M
authors: Tomasevic
authors: Miodrag
authors: M
authors: Dikic
authors: Miodrag
authors: M
authors: Ostojic
mesh_terms: D000328:Adult; D015906:Angioplasty, Balloon, Coronary; D019917:Blood Vessel Prosthesis Implantation; D020099:Coated Materials, Biocompatible; D017023:Coronary Angiography; D003331:Coronary Vessels / Q000293:injuries*; D003657:Decision Making; D006801:Humans; D008297:Male; D054084:Myocardial Bridging / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy*; D009203:Myocardial Infarction / Q000150:complications*; D011474:Prosthesis Design; D015607:Stents / Q000009:adverse effects*; D016157:Vascular Fistula / Q000209:etiology* / Q000628:therapy
chemical_list: D020099:Coated Materials, Biocompatible