Coronary endarterectomy and stent removal after iatrogenic perforation

Fukui, Toshihiro; Takanashi, Shuichiro; Mihara, Wahei; Ishikawa, Kazunori; Hosoda, Yasuhiro

doi:10.1016/s0003-4975(03)01424-3

Cited by 5 publications

(8 citation statements)

References 7 publications

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“…Coronary artery perforation is one of these serious mechanical complications requiring emergent cardiac surgery which may lead to cardiac tamponade. Fukui et al [9] reported the incidence of coronary artery perforation during PCI to be between 0.2% and 0.8% with a reported rate of 2.9% by Patel et al [8] Device entrapment, as seen in our case, also requires emergent cardiac surgery in most cases. [10] Despite low complication rates, these complications still occur.…”

Section: Discussionmentioning

confidence: 55%

Coronary artery bypass graft surgery for right coronary artery: balloon catheter entrapment

Hidiroğlu¹

2014

Turk Gogus Kalp Dama

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Aterosklerotik kalp hastalıklarında perkütan koroner girişimler yaygın uygulanmakta olup, neredeyse hastane yatışı gerektirmeden uygulanabilecek hale gelmiştir. Ancak, invaziv bir girişim olduğu için, koroner anjiyografi ve perkütan koroner girişimlerin bazı ciddi komplikasyonları olabilmektedir. Bu yazıda, perkütan koroner girişim sırasında sağ koroner arter içerisinde sıkışan ve acil koroner arter baypas grefleme gerektiren perkütan koroner girişimin bir komplikasyonunun görüldüğü 81 yaşında bir erkek olgu sunuldu. Bu yazı, son yıllara ait bazı saygın kılavuzlarda gerekli görülmemiş olmasına rağmen, perkütan koroner girişimlerin uygulandığı hastanelerde kardiyovasküler ekibin gerekliliğini vurgulamak amacıyla kaleme alınmıştır. Anah tar söz cük ler: Kalp cerrahisi; kateter sıkışması; perkütanöz koroner girişim.

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Section: Discussionmentioning

confidence: 55%

Coronary artery bypass graft surgery for right coronary artery: balloon catheter entrapment

Hidiroğlu¹

2014

Turk Gogus Kalp Dama

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“…The incidence of such complications during PCI requiring emergency coronary artery bypass grafting surgery has decreased from 2.9 % in 1999 to 0.8 % in 2003 [1]. Surgical removal of entrapped coronary angioplasty/stenting hardware has been reported, together with surgical techniques to restore the blood supply to the diseased coronary artery [2,3]. Following stent removal, we performed an open endarterectomy because the intima had been badly torn by the stent and guidewire.…”

Section: Discussionmentioning

confidence: 99%

“…Surgical removal of entrapped equipment is mandatory if these methods fail. Angioplasty (autologous vein patch or on-lay internal thoracic artery [ITA] patch) of the coronary artery or vessel ligation with distal aorta-coronary bypass have usually been performed following stent removal and eventual coronary artery endarterectomy [2,3]. We present a patient in whom a coronary-coronary autologous vein conduit was used to reconstruct the disintegrated left anterior descending (LAD) coronary artery bed following removal of a protection wire entrapped in the coronary stent.…”

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confidence: 99%

Coronary-Coronary Bypass to Reconstruct Coronary Artery Bed following Removal of a Guidewire Entrapped in a Stent

Mićović

Nežić²,

Mangovski³

et al. 2009

Thorac cardiovasc Surg

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Cardiac surgeons are treating an increasing number of patients after different sorts of complications occurring during various percutaneous procedures. Wire entrapment has been described in the literature and numerous maneuvers have been developed to solve this complication. If they fail, surgical management is absolutely indicated. In such cases the operation can be very demanding. After hardware removal the artery quality is usually unsatisfactory and endarterectomy with adjacent revascularization is mandatory. We report a case in which we used a termino-terminal interposition of the greater saphenous vein to restore a disintegrated part of the coronary artery.

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“…There is very little available in the published literature. [1][2][3][4] We hope our small experience will help the doctors in making decisions in helping their patients.…”

Section: Casementioning

confidence: 99%

Coronary Artery Bypass Grafting in Patients with Intracoronary Stent Related Complications

Siraj

Hasan

2012

Univ. Heart J.

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IntroductionThere has been a change lately in the way we help patients with coronary artery disease. Cardiologists are becoming more aggressive with percutaneous coronary artery interventions. Now multiple, complex, diffuse and smaller coronary vessels are being stented. As a result the surgeons are being referred patients with extensive, diffuse vessels for coronary artery bypass grafting (CABG). Increasing stent insertion is also resulting in more procedure related complications like undeployed or improperly deployed stents. Furthermore complications resulting from the natural progression of coronary artery disease such as stenosis before, within and after the stent are increasing. These are putting forward new set of challenges in front of the surgeon wishing to help the patients with CABG.We present our experience with two different cases. One represents complications due to natural progression of atherosclerosis and the other an example of procedural problems. Case Summary Case 1:A fifty four year old hypertensive, diabetic and dyslipidaemic gentle man was admitted to the coronary care unit (CCU) of our hospital on 26.08.06. He complained of sudden severe compressive chest pain without any radiation and associated with severe sweating for the last one hour. This patient also gave a history of anterior myocardial infarction (MI) in 2003. During that episode he was thrombolysed in another hospital followed by per cutaneous intervention (PCI) to the left anterior descending (LAD) artery in our hospital. Two stents were implanted in tandem at the time. However the patient had lost all documentations from that admission. The patient was stabilized as per established medical management protocols including thrombolysis. Thereafter a repeat coronary angiogram (CAG) was done on 30.08.06. There was also an osteal stenosis of the large diagonal (Fig 1 &2) This showed in stent restenosis along the entire length of the implanted stents. The patient continued to have intermittent chest pain at rest with ECG changes despite maximum medical management. The patient was discussed between the cardiologists and the surgeons and it was decided to graft the distal LAD and the large diagonal with a view to relieve the symptoms. Echo study showed apex dyskinetic, basal and mid portion of anterior septum severely hypokinetic, diastolic dysfunction grade II, Ejection Fraction (EF) 40%. Coronary Artery Bypass Grafting in Patients withThe patient was taken to the operating room (OR) on 07.09.06. Under general anaesthesia the heart was approached via a median sternotomy. The patient was attached to the heart lung machine using routine aortic and two stage single venous cannulation. On bypass the patient was cooled down to 28 degree Celsius, aorta cross clamped and the heart was arrested with antegrade cold blood cardioplegia. On palpating the LAD we found to our horror that the stents extended to cover most of the length of the vessel. The short distal segment that was free of stents lumen not accepting a 1.0 mm metal probe. We realize...

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Coronary endarterectomy and stent removal after iatrogenic perforation

Cited by 5 publications

References 7 publications

Coronary artery bypass graft surgery for right coronary artery: balloon catheter entrapment

Coronary artery bypass graft surgery for right coronary artery: balloon catheter entrapment

Coronary-Coronary Bypass to Reconstruct Coronary Artery Bed following Removal of a Guidewire Entrapped in a Stent

Coronary Artery Bypass Grafting in Patients with Intracoronary Stent Related Complications

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