Perforation of Right Coronary Artery During Coronary Angioplasty: A Rare Complication

Coronary angioplasty procedure, also known as percutaneous transluminal coronary angioplasty (PTCA), is performed to restore blood flow across significantly blocked coronary vessels. Perforation of coronary vessels may occur rarely during the procedure or within 24 hours post-procedure and is considered a serious complication. We wish to share our experience of a case of perforation in the proximal and mid-portion of the right coronary artery (RCA) during coronary angioplasty. To seal the perforation, the balloon was inflated and vitals were monitored. Check coronary angiography showed persisting extravasation but with no collection on serial echocardiograms. It was confirmed that the perforation was not in the pericardial space but inside the cardiac chamber. The patient was shifted to the cardiac care unit, for further monitoring of vitals and echocardiogram studies for the next 72 hours to ensure recovery. Wire-induced coronary perforations into the cardiac chamber are most of the time benign and are conservatively managed.