TY - JOUR TI - Perforation of a Saphenous Vein Graft Anastomosed at a Y-Configuration to the Left Internal Mammary Artery AU - Triantafyllis, Andreas S. AU - Haeck, Joost D. E. AU - van Dijk, Eveline AU - G. J. A. AU - Brueren, Guus R. G. AU - Spartans, Eleftherios AU - Tonino, AU - Pim A. L. JO - Cardiovascular Revascularization Medicine PY - 2019 VL - 20 TODO - 8 SP - 716-719 PB - HANLEY & BELFUS-ELSEVIER INC SN - 1553-8389 TODO - 10.1016/j.carrev.2018.10.001 TODO - Perforation; Vein graft; CABG; Covered stent; Loculated tamponade TODO - Perforation of a saphenous vein graft (SVG) is a rare, yet dreadful complication during percutaneous coronary intervention (PCI). Perforation of a SVG arising at a Y-construction from the left internal mammary artery (LIMA) can be catastrophic since manipulations and material delivery through the single LIMA inflow can aggravate ischemia and accelerate hemodynamic collapse. Prior CABG and pericardial obliteration should not offer reassurance against tamponade, since coronary perforation in these patients may cause the development of loculated pericardial effusions, a complication associated with high mortality. Treating physicians must be alert for potential periprocedural pitfalls during PCI in post-CABG patients and these should be taken into consideration during interventional planning, procedure and follow-up. (C) 2018 Elsevier Inc. All rights reserved. ER -