LEFT MAIN CORONARY-ARTERY DISSECTION DURI NG STENT IMPLANTATION BECAUSE OF BALLOON RUPTURE - A CASE-REPORT

A 68-year-old female patient was admitted at our hospital because of u nstable angina pectoris. Coronary angiography revealed an 85 % diamete r stenosis in the proximal segment of the left anterior descending cor onary artery (LAD) and a 70 % diameter stenosis in the mid segment of the right coronary artery (RCA). Elective implantation of a Plamaz-Sch atz stent in the LAD stenosis and conventional angioplasty of the RCA stenosis was decided for. Positioning of the Palmaz-Schatz stent was u neventful, whereas deployment of the stent, using a pressure of 10 atm ospheres was complicated by balloon rupture, causing an extensive retr ograde dissection of the LAD, involving the left main stem, the adjace nt coronary sinus, and the proximal segment of the circumflex artery ( CX). Coronary flow was stabilized by two guide wires inserted in the L AD and CX and the patient was sent to emergency operation. The postope rative course was uneventful and there were no signs of myocardial inf arction.