ABSTRACT
This chapter presents a case study of a A 77-year-old man with unstable angina pectoris by coronary angiography had focal severe stenosis of a dominant right coronary artery, a normal left coronary system, and normal left ventricular function. PTCA of the right coronary artery was performed. The tight stenosis prevented appropriate placement of a 2-mm Gruntzig catheter; therefore, the narrowing was dilated initially by multiple inflations of a Simpson catheter advanced across a guide wire, and subsequently by a 3-mm Gruntzig catheter at 4 atm. Although percutaneous transluminal coronary angioplasty (PTCA) appears to be a relatively safe and effective procedure, reported complications include coronary occlusion and dissection with or without acute myocardial infarction. Herein, a hitherto unreported complication of PTCA is described. It is clear that the right coronary artery in the patient just described ruptured during the PTCA procedure.
