CORONARY-ARTERY PERFORATION AND DELAYED CARDIAC-TAMPONADE FOLLOWING BALLOON CORONARY ANGIOPLASTY

A 62-year-old woman who had coronary artery disease and hypertrophic c ardiomyopathy received percutaneous transluminal coronary angioplasty and endomyocardial biopsy. She withstood the procedure well. However, delayed pericardial tamponade occurred 2 hours after discharge from th e cardiac catheterization laboratory. Despite pericardial drainage wit h a pigtail catheter and blood transfusion, the patient required emerg ency surgery. An oozing diagonal branch of the left anterior descendin g coronary artery was found. Ligation of this small branch stabilized the hemodynamics. Avoidance of improper positioning of the guide Mire in the small coronary artery branch is important in preventing arteria l wall trauma and subsequent perforation.