Case study: distal perforation coils Type V perforation
08 Jun 2017
Consult this case study on using distal perforation coils, a 76-year-old male patient with dyslipidemia and hypertension.
How to treat emergency coronary perforation
Perforations can be life threating complications, but if recognised quickly and managed correctly can have a positive outcome. This section explains how to treat a coronary perforation.
In total there are 5 types.
Case study: reversing heparin Type V perforation
04 May 2017
Consult this case study on reversing heparin in a Type V coronary perforation complication, a female 76-year old patient.
Case study: thrombin injection Type V perforation
04 May 2017
Consult this case study on a thrombin injection Type IV perforation, a male 76-year old patient.
Emergency management - Type I: Epicardial segment
A Type I coronary perforation is angiographical similar to a Type C coronary dissection and reflects the notion that a continuum exists between dissection and perforation.
Treatment of a Type I coronary perforation:
Emergency management - Type II: Epicardial segment
A Type II perforation is similar to Type I in terms of management, but is associated with a higher risk of progression to Type III. Myocardial blushing is considered to be lower risk than pericardial fat staining.
Emergency management - Type III
Type III coronary perforation is the most serious perforation and expedient management is crucial in order to preserve life.
Emergency management - Type IV: Epicardial segment
A Type IV coronary perforation involves a leak into another cardiovascular cavity / cavity spilling.
Emergency management - Type V: Distal segment
Type V coronary perforation takes a look at perforation of the distal segment due to coronary guidewire tip exiting the coronary artery distally.
Once the coronary perforation has been treated there is still a risk of mortality and close surveillance is required during the first 24 hours.