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  • Title: Emergency surgery after coronary disruption complicating PTCA. Report of four cases.
    Author: Gonzalez-Santos JM, Vallejo JL, Pineda T, Zuazo JA.
    Journal: Thorac Cardiovasc Surg; 1985 Aug; 33(4):244-7. PubMed ID: 2413578.
    Abstract:
    Four out of 150 patients having a PTCA at our institution sustained a coronary artery disruption and underwent emergency surgery. All of them presented a severe stenosis of the LAD, in 2 of them there was also a stenosis at the origin of a diagonal branch. In each case the injured vessel was a diagonal branch. Three patients had a rupture of subepicardial arteries and developed cardiac tamponade. In another patient the rupture was located intramyocardially. Severe hemodynamic derangement occurred in all 4 cases, one resulting in cardiac arrest. The latter was the only patient who died postoperatively, due to neurological damage. Two of the surviving patients sustained a non-transmural myocardial infarction in the area of the injured vessel. However, all 3 survivors recovered easily and are doing well 6 months after surgery.
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