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Case Report
 
Coronary perforation during balloon anchoring after rotational atherectomy of chronic total occlusion of coronary vessel
Wei-Chieh Lee1, Chiung-Jen Wu1, Hsiu-Yu Fang1
1Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Taiwan.

Article ID: Z01201610CR10706WL
doi:10.5348/ijcri-2016118-CR-10706

Address correspondence to:
Wei-Chieh Lee
Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital
Kaohsiung 123, Ta Pei Road, Niao Sung District, Kaohsiung City, 83301, Taiwan
R.O.C. No.123, Ta Pei Rd, Niao-Sung district, Kaohsiung City,
Taiwan

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How to cite this article
Lee Wei-Chieh, Wu Chiung-Jen, Fang Hsiu-Yu. Coronary perforation during balloon anchoring after rotational atherectomy of chronic total occlusion of coronary vessel. Int J Case Rep Images 2016;7(10):666–670.


Abstract
An 87-year-old Asian male experienced progressive shortness of breath for two days. He presented symptoms and signs of decompens-ated heart failure and was diagnosed as non ST-segment elevation myocardial infarction, killip III. Coronary intervention was performed for chronic total occlusion of left anterior descend-ing artery. Unfortunately, coronary perforation happened during balloon anchoring after rotational atherectomy. Rotational atherectomy may be not related to perforation, but causes vessel wall more fragile after disruption of the arc of calcification. Even if balloon anchoring was performed at low pressure, we need keep in mind that it still could result in a terrible coronary perforation after debulking techniques. Covered stents for emergency implantation in case of coronary perforation must be an obligatory inventory of catheterization laboratories. It is an effective alternative that can be used to seal a major coronary perforation.

Keywords: Cardiac tamponade, Chronic total occlusion, Coronary perforation, Rotational atherectomy


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Author Contributions
Wei-Chieh Lee – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Chiung-Jen Wu – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Hsiu-Yu Fang – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© 2016 Wei-Chieh Lee et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.



About The Authors

Wei-Chieh Lee is a Medical Doctor and an Interventionist at Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital. His area of interest include coronary artery disease and arrhythmia. He has published 35 research papers and case reports. He intends to pursue PhD of cardiology in future.



Chiung-Jen Wu is a Professor and a Renowned Interventionist at Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital. His area of interest include coronary artery disease and chronic total occlusion and complex intervention. He has published more than 100 research papers and is a head of the Taiwan Society of Cardiovascular Interventions (TSCI).



Hsiu-Yu Fang is an Associate Professor and a Renowned Interventionist at Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital. His area of interest include coronary artery disease and chronic total occlusion and complex intervention. He has published more than 70 research papers and case reports in the field of intervention and coronary artery disease.