engleski

Left circumflex artery rupture in subacute STEMI

The clinical case report of 69-years old male with subacute posterolateral left ventricular wall STEMI and rupture of the left circumflex coronary artery during postdilatation after DES deployment. Patient was hemodinamically unstable, with clinical signs of shock and echocardiographic evidence of cardiac tamponade. Emergency pericardiocentesis was performed with orotracheal intubation in rapid sequence induction, and mechanical ventilation. Coronary rupture was treated with stent-graft deployment, but coronary dissection emerged and extended to distal segment of the artery with contrast extravasation. Patient was further treated with another inflation of NC balloon catheter (6 atm) with coronary artery occlusion, 0, 018” microchateter over 300 cm workhorse coronary guidewire and six pieces of pushable embolization coils. About 1000 ml of blood was evacuated. After five days in CCU, he was transfered to the ward and discharged from the hospital nine days after the percutaneous coronary intervention. Control TTE revealed LVEF of 40%, with lateral wall akinesia, inferior wall hypokinesia, and no pericardial effusion.

myocardial infarction, coronary artery, percutaneous coronary intervention

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