Management of Coronary Artery Perforation in Acute ST-Segment Elevation Myocardial Infarction

Abstract

Background: Coronary Artery Perforation is a rare Percutaneous Coronary Intervention (PCI) complication which may lead to pericardial effusion frequently accompanied by tamponade. This complication occurs in 0.2 to 0.6% of all patients undergoing the procedures. The initial approach commonly comprises prolonged balloon inflation, placement of a covered stent graft (CSG), pericardiocentesis, or urgent coronary artery bypass graft (CABG) surgery.

The aim: To present a patient with a type III Ellis classification of coronary artery perforation, who had previously underwent primary PCI due to an acute extensive anterior STEMI, and discussed its management

Conclusion: Management of coronary artery perforation can be customized based on the categorization and hemodynamic condition of the hole. Our patient was effectively managed with extended balloon inflations and intra-coronary vitamin K administration without the need for surgical management intervention.