Four out of 150 patients having a PTCA at our institution sustained a coronary artery
disruption and underwent emergency surgery. All of them presented a severe Stenosis
of the LAD, in 2 of them there was also a Stenosis at the origin of a diagonal branch.
In each case the injured vessel was a diagonal branch. Three patients had a rupture
of subepicardial arteries and developed cardiac tamponade. In another patient the
rupture was located intramyocardially. Severe hemodynamic derangement occurred in
all 4 cases, one resulting in cardiac arrest. The latter was the only patient who
died postoperatively, due to neurological damage. Two of the surviving patients sustained
a non-transmural myocardial infarction in the area of the injured vessel. However,
all 3 survivors recovered easily and are doing well 6 months after surgery.
PTCA - Coronary disruption - Cardiac tamponade - Emergency surgery
