Management of Iatrogenic Aortic Dissections During Percutaneous Right Coronary Artery Interventions

Gennari, Marco; Mastroiacovo, Giorgio; Polvani, Gianluca; Fabbiocchi, Franco; Agrifoglio, Marco

doi:10.21470/1678-9741-2020-0570

Cited by 1 publication

(1 citation statement)

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“…Type 1 - dissection limited to sinuses of Valsalva, type 2 - dissection of the ascending aorta outside of the sinuses (4 cm), and type 3 - dissection >/= 4 cm. According to these authors, stent placement was adequate for the limited forms, while surgery was necessary for patients with type 3 [ 3 , 5 ]. The reported mortality rate for surgically managed IAD, in conjunction with heart surgery is almost double that of surgically managed spontaneous aortic dissection [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Iatrogenic Aorto-Coronary Dissection: A Rare Complication With Fatal Prognosis

Pamulapati,

Taduru,

Janga

et al. 2024

Cureus

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Iatrogenic aorto-coronary dissection (IACD) is a rare complication of interventional and surgical cardiac procedures, with a very high mortality burden. Here, we report the case of a 71-year-old female with a past medical history of paroxysmal atrial fibrillation, mild to moderate aortic insufficiency, hypertension, and hyperlipidemia, who presented with classic anginal symptoms and underwent a cardiac catheterization, during which she suffered Iatrogenic right coronary artery (RCA) dissection and ascending aortic dissection resulting in sudden death. IACD is a rare complication, with a fatal prognosis. Coronary angiography and percutaneous coronary intervention (PCI) are considered safe, with a low risk of major complications including coronary perforations, and a very low risk of Iatrogenic aortic dissection (IAD). The coronary injury occurs more commonly during PCI of chronic total occlusion (CTO) or RCA interventions and can extend to the aortic root. IAD is often fatal and has worse outcomes than spontaneous dissection.

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Section: Introductionmentioning

confidence: 99%