Early Spontaneous Resolution of an Iatrogenic Acute Type A Aortic Dissection

Abstract

Acute aortic dissection is a rare but devastating complication during cardiac catheterization. We present the case of an elderly female who incurred a Stanford Type A/DeBakey Type I acute aortic dissection extending into the arch vessels and descending aorta likely occurring during right coronary artery engagement for angioplasty. The patient was treated successfully by immediately sealing the entrance of the dissection via the placement of a stent and anti-impulse therapy. Follow-up computed tomography scan showed complete resolution of the dissection within one month.

Iatrogenic Aortic Dissection: Review of the Literature

“…In an ad hoc review of the literature, we have tabulated the currently available case series of iatrogenic aortic dissection ( Table 1). The thrust of these case reports [1][2][3][4] and literature review (Table 1) points toward the adequacy of medical management in most cases. For dissections induced by coronary angioplasty, immediate sealing of the inciting proximal coronary tear by stenting appears important in securing safe medical outcome.…”

“…AORTA received almost simultaneously the four separate reports (included in this issue) of iatrogenic aortic dissection following coronary angioplasty [1][2][3] and transaortic aortic valve replacement [4]. Medical management was successful in all these cases.…”