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Case Reports
. 2020 Sep 7;91(3):e2020080.
doi: 10.23750/abm.v91i3.8726.

Left ventricular free-wall rupture, a potentially lethal mechanical complication of coronaric angioplasty : an unusual case report

Ludovica Marangoni  1 , Walter Serra  2 , Bruno Borrello  3 , Antonella Vezzani  4 , Andrea Ramelli  5 , Maria Alberta Cattabiani  6
Affiliations
Case Reports

Left ventricular free-wall rupture, a potentially lethal mechanical complication of coronaric angioplasty : an unusual case report

Ludovica Marangoni et al. Acta Biomed. .

Abstract

The incidence of complications of coronary perforation varied significantly among studies probably due to population heterogeneity and interventional techniques applied in each centre. Free wall rupture, cardiac tamponade and miocardial infarction are the most feared. The treatment of perforation remains a challenge of every cath- lab team. The management strategies range from observation to urgent operation depending on patient's hemodynamic status, severity and location of the perforation, coronary anatomy, interventional practice and equipment in each centre and operators' skills on-site. In this case an extracorporeal circulation and cardioplegic arrest with anterograde hot blood cardioplegia was done. A composite Dacron with autologous pericardium patch was used for left ventricular free wall rupture repair and the geometry of the left ventricle was restored. Subsequently aorta was declamped; the patient was weaned from CEC and a good spontaneous hemodynamic was recovered.

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Conflict of interest statement

Each author declares that he or she has no commercial associations (e.g. consultancies, stock ownership, equity interest, patent/licensing arrangement etc.) that might pose a conflict of interest in connection with the submitted article

Figures

Figure 1.
Figure 1.
Small depot of contrast around the stented vessel segment
Figure 2.
Figure 2.
ECO-TT showing respiratory variation at the mitral valve consistent with tamponade physiology
Figure 3.
Figure 3.
Intramural ventricular haematoma of the inferior-lateral wall of the left ventricle with parietal haemorrhagic infarction
See this image and copyright information in PMC

References

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