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Case Reports
. 2024 Feb 20;8(4):ytae100.
doi: 10.1093/ehjcr/ytae100. eCollection 2024 Apr.

A missing coronary guidewire mimicking aortic dissection-a case report

Ziad Arow  1   2 , Avigdor Bar Sef  1   2 , Abid Assali  1   2 , Yoav Arnson  1   2
Affiliations
Case Reports

A missing coronary guidewire mimicking aortic dissection-a case report

Ziad Arow et al. Eur Heart J Case Rep. .

Abstract

Background: A retained coronary guidewire following coronary angiography is an extremely rare complication. We present a case of a retained coronary guidewire from a percutaneous coronary intervention done 2 years ago.

Case summary: An 80-year-old asymptomatic man with a history of ischemic heart disease and moderate aortic stenosis presented to the echocardiography lab for routine follow-up. Transthoracic echocardiography showed Moderate aortic stenosis and a suspected linear echogenic structure in the ascending aorta. trans-esophageal echocardiography was performed to reveal a mobile and linear echogenic structure originating from the sinuses of Valsalva/Sinotubular junction and extending to the ascending aorta. An electrocardiogram gated cardiac computed tomography was performed and showed A linear well-defined structure originating from the ostium of the left main coronary artery and extending to the ascending aorta-a coronary guidewire from an earlier procedure. A second look at the last invasive coronary angiography record demonstrated the same finding. A multidisciplinary heart team discussion was obtained and concluded that the risk of surgical or endovascular intervention outweighed the potential benefit. The patient was discharged home for a close clinical and echocardiographic follow-up.

Discussion: A retained coronary guidewire is a rare complication that operators should be aware of. Management should be case-specific depending on clinical presentation.

Keywords: Aortic dissection; Cardiac computed tomography; Case report; Coronary guidewire; Echocardiography.

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Conflict of interest statement

Conflict of interest: none.

Figures

Figure 1
Figure 1
Transthoracic echocardiography.
Figure 2
Figure 2
Trans-esophageal echocardiography.
Figure 3
Figure 3
Twelve lead electrocardiogram.
Figure 4
Figure 4
Electrocardiogram gated cardiac computed tomography.
None
See this image and copyright information in PMC

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