title: [Penetrating injury of the coronary artery by a stump of suture for closure of esophageal musle layer].
abstract: We report a case of a 57-year-old woman who presented with cardiac tamponade 13 days after thoracoscopic excision of the diverticulum of the esophagus. Computed tomography and electrocardiogram revealed neither evidence of aortic dissection nor acute myocardial ischemia. Unstable hemodynamic condition continued even after 400 ml blood drainage through pericardiocentesis, and emergency open surgery was performed. Active arterial bleeding was seen at the marginal branch of the left circumflex coronary artery. The stump of the suture [4-0 polydioxanone (PDS) II], which had been used for closure of the overlying esophageal muscle layer, penetrated the pericardium and injured the coronary artery. Vessel injury caused by a stump of a suture seems to be extremely rare. Careful selection of the suture around the pericardium and management of its stump are necessary.
authors.affiliation: Department of Cardiovascular Surgery, Sanin Rosai Hospital, Yonago, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Kuroda
authors.forename: Kimiyo
authors.initials: K
authors.lastname: Ono
mesh_terms: D003331:Coronary Vessels / Q000293:injuries*; D004936:Diverticulum, Esophageal / Q000601:surgery; D004947:Esophagus / Q000601:surgery*; D005260:Female; D006801:Humans; D008875:Middle Aged; D013537:Sutures / Q000009:adverse effects*