article · Scholars Journal of Medical Case Reports
Coronary artery perforation during elective percutaneous coronary intervention is a severe complication that can cause cardiac tamponade and poses difficult management challenges. A clinical case involved a 76-year-old male presenting with paroxysmal supraventricular tachycardia and accelerating chronic coronary syndrome caused by significant stenosis in the mid-left anterior descending artery at the first diagonal bifurcation. During provisional stenting using a jailed guidewire to protect the diagonal branch, the patient experienced haemodynamic instability and cardiac tamponade due to distal perforation of the diagonal branch caused by the wire. Clinicians resolved the life-threatening situation and restored haemodynamic stability through emergency pericardiocentesis, blood transfusion, and the deployment of a covered stent across the mid-left anterior descending artery, which deliberately sacrificed the ostium of the diagonal branch to achieve a satisfactory outcome.
Percutaneous coronary interventions carry rare but critical risks where protective procedural steps can inadvertently cause severe internal bleeding around the heart. Demonstrating how clinicians address sudden perforations using emergency fluid drainage and covered stents provides valuable insights for medical teams navigating unexpected life-threatening complications during complex cardiovascular interventions.
The abstract describes a single clinical case report and does not indicate an application pathway.
AI-generated from the published abstract. Always read the original work before citing.
The coronary artery perforation during elective percutaneous coronary intervention is a nightmare for interventional cardiologists and one of the most common complications that lead to cardiac tamponade and is always hard to manage timely and properly [1]. We report the case of a 76-year-old male who developed a paroxysmal supraventricular tachycardia with an accelerating chronic coronary syndrome due to a significant mid-left anterior descending artery [LAD] stenosis involving the first diagonal bifurcation. During provisional stenting of the mid-LAD with protection of the diagonal branch via a jailed guidewire, hemodynamic instability and cardiac tamponade occurred secondary to distal perforation of the first diagonal branch by the protection wire. Pericardiocentesis, transfusion and a covered stent deployed across the mid-LAD, deliberately sacrificing the diagonal branch ostium restored a hemodynamic stability and a satisfying result was achieved.
This page summarises published work. The authoritative version sits with the publisher.
DOI: 10.36347/sjmcr.2026.v14i08.027
Is something wrong with this record? Report it or request removal.
Discussion
Have you built on this work, tried to replicate it, or seen it applied in practice? Share what you know. Verified researchers and MARATTO™ domain experts can open a discussion, and any member can reply. Contributions are reviewed before they appear.
No discussion yet. Open the first thread.
New to MARATTO™? Create a free account.
