Successful management of Ellis III coronary perforation and complex bifurcation lesion of the right coronary artery in a patient with high- risk coronary anatomy. A case report

Kevin Velarde-Acosta; José Raúl Delgado Arana; José M. Medina-Maguiña; Roberto Baltodano-Arellano

doi:10.47487/apcyccv.v4i3.313

Autores/as

Kevin Velarde-Acosta Servicio de Cardiología Clínica. Hospital Guillermo Almenara Irigoyen - EsSalud, Lima, Perú. https://orcid.org/0000-0001-9132-0445
José Raúl Delgado Arana Departamento de Cardiología Intervencionista. Hospital Guillermo Almenara Irigoyen - EsSalud, Lima, Perú. https://orcid.org/0000-0002-9113-3022
José M. Medina-Maguiña Servicio de Cardiología Clínica. Hospital Guillermo Almenara Irigoyen - EsSalud, Lima, Perú. https://orcid.org/0000-0002-5167-5580
Roberto Baltodano-Arellano Departamento de Imagen Cardiaca. Hospital Guillermo Almenara Irigoyen - EsSalud, Lima, Perú. https://orcid.org/0000-0002-7538-2125

DOI:

https://doi.org/10.47487/apcyccv.v4i3.313

Palabras clave:

Percutaneous Coronary Intervention, Complications, Heart Failure

Resumen

Complex coronary lesions represent challenging findings for percutaneous coronary intervention and potentially lead to complications during their approach. We present the case of a patient with decompensated heart failure of ischemic origin who presented multiple complex lesions on coronary angiography. The initial approach to the marginal artery was complicated by a severe coronary perforation that was satisfactorily resolved and in the second moment, a bifurcation lesion of the right coronary artery was successfully treated using the inverted Culotte technique.

Descargas

Los datos de descarga aún no están disponibles.

Referencias

Konigstein M, Redfors B, Zhang Z, Kotinkaduwa LN, Mintz GS, Smits PC, et al. Utility of the ACC/AHA Lesion Classification to Predict Outcomes After Contemporary DES Treatment: Individual Patient Data Pooled Analysis From 7 Randomized Trials. J Am Heart Assoc. 2022;11(24):e025275. doi:10.1161/JAHA.121.025275.

Shimony A, Joseph L, Mottillo S, Eisenberg MJ. Coronary artery perforation during percutaneous coronary intervention: a systematic review and meta-analysis. Can J Cardiol. 2011;27(6):843-50. doi: 10.1016/j.cjca.2011.04.014.

Gunning MG, Williams IL, Jewitt DE, Shah AM, Wainwright RJ, Thomas MR. Coronary artery perforation during percutaneous intervention: incidence and outcome. Heart. 2002;88(5):495-8. doi: 10.1136/heart.88.5.495.

Gruberg L, Pinnow E, Flood R, Bonnet Y, Tebeica M, Waksman R, et al. Incidence, management, and outcome of coronary artery perforation during percutaneous coronary intervention. Am J Cardiol. 2000;86(6):680-2, A8. doi: 10.1016/s0002-9149(00)01053.

Nagalli S, Hajouli S. Coronary Artery Perforation. [Updated 2023 Jul 3]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan. Available from: https://www.ncbi.nlm.nih. gov/books/NBK554476/

Kırat T. Fundamentals of percutaneous coronary bifurcation interventions. World J Cardiol. 2022;14(3):108-38. doi: 10.4330/ wjc.v14.i3.108.

Zhang JJ, Ye F, Xu K, Kan J, Tao L, Santoso T, et al. Multicentre, randomized comparison of two-stent and provisional stenting techniques in patients with complex coronary bifurcation lesions: the DEFINITION II trial. Eur Heart J. 2020;41(27):2523-36. doi: 10.1093/eurheartj/ehaa543.

Perera D, Clayton T, O’Kane PD, Greenwood JP, Weerackody R, Ryan M, et al. Percutaneous Revascularization for Ischemic Left Ventricular Dysfunction. N Engl J Med. 2022;387(15):1351-60. doi: 10.1056/NEJMoa2206606.