Successful management of Ellis III coronary perforation and complex bifurcation lesion of the right coronary artery in a patient with high-risk coronary anatomy. A case report.

ABSTRACT

Complex coronary lesions represent challenging findings for percutaneous coronary intervention and potentially lead to complications during their approach. We present the case of a patient with decompensated heart failure of ischemic origin who presented multiple complex lesions on coronary angiography. The initial approach to the marginal artery was complicated by a severe coronary perforation that was satisfactorily resolved and in the second moment, a bifurcation lesion of the right coronary artery was successfully treated using the inverted Culotte technique.

RESUMEN

Las lesiones coronarias complejas representan hallazgos desafiantes para la intervención coronaria percutánea y potencialmente exponen a complicaciones durante su abordaje. Reportamos el caso de un paciente con falla cardíaca descompensada de etiología isquémica que en la angiografía coronaria presentó múltiples lesiones complejas. El abordaje inicial de la arteria marginal se complicó con una perforación coronaria severa que se trató con éxito; en un segundo momento se abordó satisfactoriamente una lesión en bifurcación de la coronaria derecha con técnica de Culotte invertido.