Myocardial Bridge Stenting Complicated by Coronary Artery Perforation and MidLAD-Right Ventricle Fistula Formation in NSTEMI Patient

Abstract

We report a case of a patient who presented with non ST-elevation myocardial infarction and coronary angiography showing a long myocardial bridge (MB) of the left anterior descending artery (LAD) with a fixed significant stenosis at the entry point of the MB. The lesion was treated with a semi-compliant balloon and drug-eluted stent (DES). After the stent placement, a large arterial perforation with fistula to right ventricle was observed. There was no hemodynamic instability due to the fistula progression during the procedure and the perforation point was successfully closed with a stent-graft. Additionally, we provide a short review of diagnostic and therapeutic approach to MB stenting and reports of cases with coronary artery perforation after stenting of MB.

Keywords

• Coronary intervention
• Bridging
• Stent
• Perforation