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Document Details : Title: Stenting a myocardial bridge: a wrong decision in STEMI? Author(s): M. Tomasevic , M. Dikic , M. Ostojic Journal: Acta Cardiologica Volume: 66 Issue: 1 Date: 2011 Pages: 89-91 DOI: 10.2143/AC.66.1.2064974 Abstract : In a STEMI setting, stent implantation for a myocardial bridge (MB) with significant systolic compression in the mid LAD, is a challenging issue. The risk of coronary rupture during stent implantation arises from: (i) a thin intima of the bridged artery; (ii) a thin myocardial layer toward the right ventricle; (iii) a smaller LAD diameter in the MB; (iv) high inflation pressure in the balloon. Perforation with a coronary fistula resolving spontaneously within several months is one of the possible scenarios. We report a case of a coronary fistula between mid LAD and right ventricle after MB stenting in a patient with STEMI, with spontaneous angiographic deterioration after several days. Stent graft implantation in case of a coronary fistula with increasing flow is an effective therapeutic concept. |
