Iatrogenic acute coronary occlusion during epicardial ventricular tachycardia ablation: when intravascular imaging guides the management-a case report.

IF 0.8 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

European Heart Journal: Case Reports Pub Date : 2025-07-28 eCollection Date: 2025-08-01 DOI:10.1093/ehjcr/ytaf358

Filippo Russo, Ciro Vella, Filippo Maria Cauti, Vittorio Romano, Marco Gamardella, Marco Bruno Ancona, Alaide Chieffo, Matteo Montorfano

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引用次数: 0

Abstract

Background: Ventricular epicardial mapping and ablations pose a significant risk of multiple complications, such as iatrogenic injuries to the coronary arteries.

Case summary: We report a case of acute coronary occlusion during epicardial ventricular tachycardia ablation, detected by ST-segment elevation during the procedure. The multidisciplinary consultation, combined with the use of multimodality imaging, led to the final diagnosis of extrinsic compression caused by a parietal haematoma. This diagnosis guided the decision for conservative management and allowed the team to avoid stent implantation.

Discussion: This case report highlights how multidisciplinary consultation and intravascular ultrasound guidance could lead to a conservative balloon angioplasty treatment strategy, avoiding stent implantation.

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心外膜室性心动过速消融期间的医源性急性冠状动脉闭塞：当血管内成像指导治疗时- 1例报告。

背景：室性心外膜标测和消融具有多种并发症的显著风险，如医源性冠状动脉损伤。病例总结：我们报告一例心外膜室性心动过速消融期间急性冠状动脉闭塞，在手术过程中通过st段抬高检测到。多学科会诊，结合多模态影像学检查，最终诊断为由顶骨血肿引起的外源性压迫。该诊断指导了保守治疗的决定，并允许团队避免支架植入。讨论：本病例报告强调了多学科咨询和血管内超声引导如何导致保守的球囊血管成形术治疗策略，避免支架植入。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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