Interventricular Septal Hematoma after Retrograde Intervention for a Chronic Total Occlusion of a Right Coronary Artery: Echocardiographic and Magnetic Resonance Imaging—Diagnosis and Follow-UpReport as inadecuate




Interventricular Septal Hematoma after Retrograde Intervention for a Chronic Total Occlusion of a Right Coronary Artery: Echocardiographic and Magnetic Resonance Imaging—Diagnosis and Follow-Up - Download this document for free, or read online. Document in PDF available to download.

Case Reports in Medicine - Volume 2016 2016, Article ID 8514068, 6 pages -

Case ReportDepartment of Cardiology, Tsuchiura Kyodo General Hospital, Ibaraki 300-0053, Japan

Received 1 November 2015; Accepted 22 December 2015

Academic Editor: Michael S. Firstenberg

Copyright © 2016 Makoto Araki et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The reverse CART technique provides the potential to modify the retrograde procedure by improving the controlled movement of the retrograde wire and improve the success rates of percutaneous coronary intervention PCI of chronic total occlusion CTO. Development of interventricular hematoma is a rare complication of CTO PCI. A 63-year-old man with effort angina with a right coronary artery CTO lesion underwent PCI by retrograde approach from the LAD to a septal branch. A contrast -stain- was demonstrated surrounding the septal collateral channel used for the retrograde approach at the end of the procedure without symptom. Echocardiography indicated an increased interventricular septum thickness with low echo signals region and decreased contractility. Cardiac magnetic resonance CMR imaging using gadolinium showed a diffusely thickened septum with a low signal fusiform neocavitation delimited by an enhanced-signal ring suggesting intraventricular septal dissecting hematoma. After conservative treatment, follow-up echocardiogram and CMR showed the resolution of the hematoma without clinical events. This case highlights the potentially lethal complication of septal perforator dissection and hematoma that may cause severe myocardial injury caused by retrograde approach for CTO PCI.





Author: Makoto Araki, Tadashi Murai, Yoshihisa Kanaji, Junji Matsuda, Eisuke Usui, Takayuki Niida, Sadamitsu Ichijo, Rikuta Hamaya,

Source: https://www.hindawi.com/



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