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SHR Neuro Cancer Cardio Lipid Metab Microb

Achim, A; Harb, S; Toth, GG; Krivoshei, L; Leibundgut, G.
Conservative treatment for cavity spilling coronary perforations.
Cardiovasc Revasc Med. 2022; Doi: 10.1016/j.carrev.2022.08.007 (- Case Report)
Web of Science PubMed FullText FullText_MUG

Co-authors Med Uni Graz: Harb Stefan; Toth-Gayor Gabor
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Abstract:: Coronary perforation leading to shunting to other cardiac chambers is a rare complication of percutaneous coronary intervention (PCI), and most cases reported aggressive treatment with either a covered stent, coiling, or protamine injection. We report herein two cases, one of a fairly large cavity-spilling perforation of the left anterior descending coronary artery into the right ventricle and one spilling in the coronary vein. Both iatrogenic shunts were treated conservatively, and angiographic follow-up showed spontaneous resolution, suggesting that the outcome in this type of perforation may be favorable with conservative therapy. We also propose a management strategy on how to differentiate such contrast extravasations, find which cavity is communicating with the vessel and when to intervene more decisively. SOCIAL MEDIA ABSTRACT: We report herein two "fortunate" perforations, one of a fairly large cavity-spilling perforation from the left anterior descending coronary artery into the right ventricle and one spilling in the coronary vein. The angiographic follow-up showed spontaneous healing due to spilling in low-pressure cavities. A "no-touch" strategy is preferred if the patient remains asymptomatic and the pericardium free of fluid.