Coronary artery perforation in a patient with STEMI and a myocardial bridge: an increased risk for coronary artery perforation?

Tobias Becher; Stefan Baumann; Aydin Huseynov; Michael Behnes; Martin Borggrefe; Ibrahim Akin

doi:10.1016/j.carrev.2015.03.004

Coronary artery perforation in a patient with STEMI and a myocardial bridge: an increased risk for coronary artery perforation?

Cardiovasc Revasc Med. 2015 Jun;16(4):246-8. doi: 10.1016/j.carrev.2015.03.004. Epub 2015 Mar 21.

Authors

Tobias Becher¹, Stefan Baumann², Aydin Huseynov², Michael Behnes², Martin Borggrefe², Ibrahim Akin²

Affiliations

¹ First Medical Department, Faculty of Medicine Mannheim, University of Heidelberg, Mannheim, Germany. Electronic address: Tobias.Becher@umm.de.
² First Medical Department, Faculty of Medicine Mannheim, University of Heidelberg, Mannheim, Germany.

PMID: 25842348
DOI: 10.1016/j.carrev.2015.03.004

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.

Keywords: Coronary artery perforation; Myocardial bridge; STEMI.

Publication types

Case Reports
Review

MeSH terms

Aged
Coronary Artery Disease / diagnostic imaging*
Coronary Vessels / injuries
Coronary Vessels / pathology*
Humans
Myocardial Infarction / diagnosis
Myocardial Infarction / physiopathology
Myocardial Infarction / therapy*
Radiography
Risk
Stents*