title: Coronary artery perforation in a patient with STEMI and a myocardial bridge: an increased risk for coronary artery perforation?
abstract: We present the case of a patient with ST-elevation myocardial infarction (STEMI) due to subtotal occlusion of the left anterior descending coronary artery caused by an atherosclerotic lesion and a myocardial bridge (MB). Stenting of the MB caused coronary artery perforation resulting in a fistula to the right ventricle that was closed by implantation of a PTFE-covered stent. Follow-up coronary angiography showed persistent shunting, which was sealed by inflation of a high-pressure balloon over the site of extravasation guided by intravascular ultrasound. Additionally, we provide a short review of cases with coronary artery perforation after stenting of an MB.
authors.affiliation: First Medical Department, Faculty of Medicine Mannheim, University of Heidelberg, Mannheim, Germany. Electronic address: Tobias.Becher@umm.de.
authors.forename: Tobias
authors.initials: T
authors.lastname: Becher
authors.affiliation: First Medical Department, Faculty of Medicine Mannheim, University of Heidelberg, Mannheim, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Baumann
authors.affiliation: First Medical Department, Faculty of Medicine Mannheim, University of Heidelberg, Mannheim, Germany.
authors.forename: Aydin
authors.initials: A
authors.lastname: Huseynov
authors.affiliation: First Medical Department, Faculty of Medicine Mannheim, University of Heidelberg, Mannheim, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Behnes
authors.affiliation: First Medical Department, Faculty of Medicine Mannheim, University of Heidelberg, Mannheim, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Borggrefe
authors.affiliation: First Medical Department, Faculty of Medicine Mannheim, University of Heidelberg, Mannheim, Germany.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Akin
mesh_terms: D000368:Aged; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D003331:Coronary Vessels / Q000293:injuries / Q000473:pathology*; D006801:Humans; D009203:Myocardial Infarction / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D011859:Radiography; D012306:Risk; D015607:Stents
keywords: Coronary artery perforation; Myocardial bridge; STEMI