Himanshu Mahla, Rangaraj Ramalingam, Shivanand Patil, Kasam S

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Coronary perforation with cardiac tamponade – Bailed out with the covered stent Himanshu Mahla, Rangaraj Ramalingam, Shivanand Patil, Kasam S. Subramanyam, Cholenahally N. Manjunath Journal of Indian College of Cardiology Volume 4, Issue 3, Pages 194-196 (September 2014) DOI: 10.1016/j.jicc.2014.02.015 Copyright © 2014 Indian College of Cardiology Terms and Conditions

Fig. 1 Cine images demonstrating coronary perforation and various steps in its management. A: Left coronary angiogram in RAO-cranial projection showed a diffuse long segment 90% stenosis in mid LAD artery. B: A 2.75 × 32 mm DES was deployed at 12-atm in the mid LAD. C: Check angiogram after post-dilatation of the stent showed Ellis type III perforation at distal end of the stented segment with extravasation (C – white arrow) of dye. D: Bed-side transthoracic echocardiogram revealed a moderate pericardial effusion with cardiac tamponade. E: After failed attempt, a 3.0 × 20 mm covered stent (black arrows) was deployed at 14-atm over the perforation site. F: Check angiogram in RAO-cranial projection showed successful sealing of the perforation with distal TIMI III flow. RAO: right anterior oblique; LAD: left anterior descending; DES: drug eluting stent. Journal of Indian College of Cardiology 2014 4, 194-196DOI: (10.1016/j.jicc.2014.02.015) Copyright © 2014 Indian College of Cardiology Terms and Conditions