Left ventricular free-wall rupture, a potentially lethal mechanical complication of coronaric angioplasty: an unusual case report

The incidence of complications of coronary perforation varied significantly among studies prob-ably due to population heterogeneity and interventional techniques applied in each centre. Free wall rupture, cardiac tamponade and miocardial infarction are the most feared. The treatment of perforation remains a challenge of every cath- lab team. The management strategies range from observation to urgent operation depending on patient’s hemodynamic status, severity and location of the perforation, coronary anatomy, in-terventional practice and equipment in each centre and operators’ skills on-site. In this case an extracorporeal circulation and cardioplegic arrest with anterograde hot blood cardioplegia was done. A composite Dacron with autologous pericardium patch was used for left ventricular free wall rupture repair and the geometry of the left ventricle was restored. Subsequently aorta was declamped; the patient was weaned from CEC and a good spontaneous hemodynamic was recovered