PMC7085420_01
Bifurcation stenting from the saphenous vein graft into the right coronary artery into the Ramus posterolateralis dexter and Ramus interventricularis posterior as mini-crush technique. Before (arrow = native bifurcation stenosis) (
A
), during (
B
), and after (
C
) the intervention.
10-1055-s-0040-1703006-i190341crc-1.jpg
PMC7085420_01_10-1055-s-0040-1703006-i190341crc-1.jpg
FI190341crc-1
Fig. 1 ). Following PCI, a dual-antiplatelet therapy (DAPT) was initiated by continuing acetylsalicylic acid (ASA) and adding a loading dose of clopidogrel.
Reintervention as alternating kissing balloon technique for early in-stent thrombosis. Before (
A
), during (
B
), and after (
C
) the intervention. Circle = contrast agent accumulation.
10-1055-s-0040-1703006-i190341crc-2.jpg
PMC7085420_01_10-1055-s-0040-1703006-i190341crc-2.jpg
FI190341crc-2
Fig. 2 ), without hemodynamically significant extravasation (Ellis grad II). Following the reintervention, the patient was transferred back to the intensive care unit for monitoring and the DAPT was converted to ASA and ticagrelor.
Giant intramural hematoma (*) after elective percutaneous coronary intervention via a saphenous vein graft (SVG). Transesophageal echocardiography (
A
); computed tomography (CT) scan: axial (
B
), sagittal (
C
); three-dimensional-volumerendering CT with an artificially created area to visualize the size of the hematoma (
D
). RA, right atrium; RV, right ventricle.
10-1055-s-0040-1703006-i190341crc-3.jpg
PMC7085420_01_10-1055-s-0040-1703006-i190341crc-3.jpg
FI190341crc-3
Emergency computed tomography scan revealed a giant isolated intramural RV hematoma ( Fig. 3 ).
Reconstruction of the right ventricular wall. Pericardium (1), epicardium (2), bovine pericardial patch (3), myocardium (4), endocardium (5), ventricle (6) and suture direction (7).
10-1055-s-0040-1703006-i190341crc-4.jpg
PMC7085420_01_10-1055-s-0040-1703006-i190341crc-4.jpg
FI190341crc-4
Fig. 4 ). Fibrin glue was then applied to fill the remaining cavity, which was then covered by a third bovine pericardial patch.