A curious case of stent fracture and left ventricular pseudoaneurysm – A rare association in the background of cardiac tuberculosis

Abstract

Cardiac involvement in tuberculosis mainly affects the pericardium, with the myocardium being rarely involved. Coronary stent infection in patients with tuberculosis is rarely described. Myocardial involvement in tuberculosis can lead to complications such as ventricular granuloma, or dysrhythmias. Here, we present the case of a 60-year-old gentleman who had a history of multiple percutaneous coronary angioplasty, and pericardiectomy for constrictive tubercular pericardial effusion. Nine months after surgery, he presented with a left ventricular pseudoaneurysm and multiple stent fractures in the right coronary artery. Myocardial involvement in tuberculosis can cause ventricular pseudoaneurysms due to contiguous involvement from the pericardium. Stent fractures are commonly associated with pyogenic infections but can occur in cardiac tuberculosis. The occurrence of a stent fracture and ventricular pseudoaneurysm in the background of cardiac tuberculosis is, however, very rare. Patients with a history of cardiac tuberculosis should always be followed for late sequelae and complications, which may be bizarre.