Alfonso RE, López FL, Martínez BP, Oliva LK, Hechevarría PS, López CG, Llerena RL

Language: Spanish
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ABSTRACT

Coronary perforation TYPE III during a SCACEST in an octogenarian patient. The type III coronary perforation is a rare complication and a high mortality, can cause cardiac tamponade, myocardial infarction, arrhythmias and even death. The use of the double platelet antiaggregation loading dose together with the unfractionated heparin dose during primary percutaneous transluminal angioplasty (PTCA), increases the risk of acute complications considerably and hinders therapeutic management. The following is a case report of a 80-year-old man who underwent primary PTCA in the course of an acute coronary syndrome with ST-segment elevation (STEMI) with 2 vessel disease including severe stenosis in the proximal descending artery and during the interventional procedure presented as a complication a Type III coronary perforation in the Circunfleja artery, which was successfully managed by angioplasty with Stent Graft at 8 atmospheres for 20 seconds. The patient evolved favorably and at 30 days elective PTCA was performed on the anterior descending artery in its proximal segment, showing a satisfactory evolution.