CORONARY - Complications
Coronary Perforation Sealed with Fat Embolization
Faten Aqilah Binti Aris1, Wan Faizal Bin Wan Rahimi Shah1, Faizal Khan Abdullah1, Afif Ashari1, Jayakhanthan Kolanthaivelu1, Shaiful Azmi Yahaya1, Kumara Gurupparan Ganesan1
National Heart Institute, Malaysia1,
Mr HT, 71 years old, gentleman with Underlying Hypertension, Hyperlipidemia, Chronic Kidney disease (stage 3). He complain of intermittent atypical chest pain, otherwise no other symptoms. His clinical examination were unremarkable. He had exercise stress test, which was positive at stage 3 (new onset LBBB). He was then referred to our center for coronary angiogram.
Echocardiography done prior to angiogram showed normal LVEF with no regional wall motion abnormality. All valves normal
Approach: Right Radial 6F
LAD: CTO distal RCA, collateral from right RCA
LCx: mild disease OM
RCA: diffused mild disease CINE1_mpeg2video.mpg lcx_mpeg2video.mpg rca_mpeg2video.mpg
This case demonstrates fat embolization in mid vessel perforation which behaves like a distal wire perforation. Early recognization and action play an important role. In dealing with perforation, the operators must be aware of methods of achieving hemostasis which may differ from the standard guideline approach. Particularly, in this case, microcatheter was used as a method to achieve hemostasis.