Key result
Septal branch perforation during retrograde CTO PCI can cause isolated LV tamponade requiring surgical drainage.
Why the study?
The complications associated with the retrograde approach for chronic total occlusion of coronary arteries have not yet been fully appreciated.
Case Report (n=1)
Highlights a rare complication of isolated left ventricular cardiac tamponade due to septal branch perforation during retrograde CTO angioplasty, manageable with autologous tissue embolization.
Alerts operators to isolated LV tamponade risk in retrograde septal CTO PCI; leaves open incidence and prevention strategies.
The retrograde approach for chronic total occlusion of coronary arteries is a new treatment strategy, although its attendant complications have not yet been fully appreciated. We report a case of isolated left ventricular cardiac tamponade caused by guidewire-induced perforation of the septal branch during the retrograde approach, which was subsequently diagnosed by computed tomography (CT) and which required surgical drainage. Guidewire-induced perforation of the septal branch was successfully treated by autologous subcutaneous tissue embolization of the perforated coronary artery. This is the first case of its kind to date.
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Matsumi et al. (2008) conducted a case report in Chronic total occlusion of coronary arteries (n=1). Retrograde approach in angioplasty was evaluated on Complication (isolated left ventricular cardiac tamponade). Guidewire-induced perforation of the septal branch during the retrograde approach for chronic total occlusion caused isolated left ventricular cardiac tamponade requiring surgical drainage.