Key result
LMCA drug-eluting stent successfully seals iatrogenic Type A aortic dissection and restores coronary flow.
Why the study?
Iatrogenic aortic dissection during coronary interventions is a rare complication with heterogeneous management in the literature.
Case Report (n=1)
No
Drug-eluting stent implantation can be a successful management strategy for iatrogenic aortic dissection involving the left main artery during percutaneous coronary intervention.
May offer a percutaneous bailout in rare iatrogenic left main dissection; leaves open need for comparative data versus surgery.
Iatrogenic aortic dissection during coronary interventions is a rare complication and has heterogeneous management in the reviewed literature. We report a case of acute aortic syndrome of traumatic etiology, during a percutaneous coronary procedure, with its management, intra-hospital evolution, and one-year follow-up. A 65-year-old female who, during a percutaneous coronary intervention, presented an endothelium trauma of the left main artery's aorta-ostial transition by the tip of the guide catheter, leading to aortic dissection and occlusion of the left main artery with hemodynamic deterioration of the patient. The left main artery's flow was restored with drug-eluting stent implantation leading to a successful sealing of the false lumen with consequent hemodynamic stabilization. Immediate post-procedure transthoracic echocardiography showed a competent aortic valve. The patient evolved favorably and remains asymptomatic after one year.
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Janella et al. (2022) conducted a case report in Iatrogenic Type A aortic dissection during acute coronary syndrome (n=1). Drug-eluting stent implantation in the left main coronary artery was evaluated on Hemodynamic stabilization and sealing of the false lumen. Implantation of a drug-eluting stent in the left main coronary artery successfully sealed an iatrogenic Type A aortic dissection and restored coronary flow, leading to hemodynamic stabilization and asymptomatic survival at 1-year follow-up.
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