Advancements in the Management of Coronary Perforation: A Case Report Demonstrating Effective Strategies and Favorable Outcomes

Abstract

Background: Coronary perforation, historically considered a perilous complication in interventional cardiology, has seen remarkable advancements in its management. Timely identification and intervention are pivotal in mitigating adverse outcomes associated with this complication.

Case Presentation: We present the case of a 63-year-old female with exertional angina and multiple comorbidities, who underwent coronary angiography revealing proximal chronic total occlusion in the right coronary artery and focal tight mid-stenosis in the left anterior descending artery. Post-dilatation in the latter resulted in grade III perforation, necessitating immediate intervention.

Management & Results: Prompt action was taken, including balloon tamponade and rapid deployment of a covered stent within the affected segment. This approach effectively sealed the perforation and restored distal flow, leading to favorable outcomes. The patient remained hemodynamically stable, with resolution of minimal pericardial effusion on serial echocardiograms.

Conclusion: This case highlights the transformative impact of advancements in the management of coronary perforation, emphasizing the importance of quick identification and decisive intervention. The utilization of covered stents offers a minimally invasive approach with favorable patient outcomes, underscoring the evolution in interventional cardiology practices.