Successful conservative management of coronary artery rupture: role of post pericardiotomy adhesions as a protective barrier.

Coronary artery rupture is a rare but potentially life-threatening complication of percutaneous coronary interventions (PCI). Grade III perforation and coronary artery rupture invariably results in pericardial effusion and tamponade requiring urgent pericardiocentesis. We report an elderly male with post coronary artery bypass status, who developed right coronary artery rupture during PCI with massive extravasation, however post pericardiotomy adhesions resulted in contained collection, thus preventing tamponade and need for pericardiocentesis. The coronary artery rupture was successfully manages with prolonged balloon dilatation followed by stenting.