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Case Reports
. 2024 Mar;63(Suppl1):54-61.
doi: 10.20471/acc.2024.63.s1.10.

MYOCARDIAL BRIDGE STENTING COMPLICATED BY CORONARY ARTERY PERFORATION AND MIDLAD-RIGHT VENTRICLE FISTULA FORMATION IN NSTEMI PATIENT

Nikola Kos  1 , Martina Čančarević  1 , Vjekoslav Radeljić  1   2 , Ozren Vinter  1 , Paola Negovetić  2 , Matias Trbušić  1   2
Affiliations
Case Reports

MYOCARDIAL BRIDGE STENTING COMPLICATED BY CORONARY ARTERY PERFORATION AND MIDLAD-RIGHT VENTRICLE FISTULA FORMATION IN NSTEMI PATIENT

Nikola Kos et al. Acta Clin Croat. 2024 Mar.

Abstract

We report a case of a patient who presented with non ST-elevation myocardial infarction and coronary angiography showing a long myocardial bridge (MB) of the left anterior descending artery (LAD) with a fixed significant stenosis at the entry point of the MB. The lesion was treated with a semi-compliant balloon and drug-eluted stent (DES). After the stent placement, a large arterial perforation with fistula to right ventricle was observed. There was no hemodynamic instability due to the fistula progression during the procedure and the perforation point was successfully closed with a stent-graft. Additionally, we provide a short review of diagnostic and therapeutic approach to MB stenting and reports of cases with coronary artery perforation after stenting of MB.

Keywords: bridging; coronary intervention; perforation; stent.

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Figures

Figure 1
Figure 1
Myocardial bridge in the midLAD segment (black line)
Figure 2
Figure 2
Coronary perforation with LAD-RV fistula formation (arrow)
Figure 3
Figure 3
Fistula diameter progression with a massive contrast leak into RV
Figure 4
Figure 4
Complete fistula closure after stent-graft implantation
See this image and copyright information in PMC

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