Iatrogenic type A aortic dissection during percutaneous coronary intervention: A single-center experience

Barış, Veysel Özgür; Asil, Serkan; Çelik, Murat; Görmel, Suat; Yuksel, Uygar Cagdas

doi:10.5543/tkda.2021.99978

Cited by 3 publications

(6 citation statements)

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“…Most published literature reported IAD as an early diagnosis during the coronary angiogram, characterized by the stagnation of contrast medium at the level of the aortic root. 2,7,11,12 In the present case, it was not apparent during the coronary angiogram, and the patient was also asymptomatic during the immediate post-op period. The clinical presentation of AD can range from asymptomatic to extreme back, chest pain.…”

Section: Discussionmentioning

confidence: 44%

“…10 IAD is a known, rare, and fatal complication following complicated cardiovascular lesions and in both diagnostic and therapeutic interventions. 11 During PCI, an IAD can be caused as the catheter is pushed into the aortic wall during the insertion of the guiding catheter. Most commonly, injuries occur at ascending aorta at the ostium of the RCA and can propagate upward.…”

Section: Discussionmentioning

confidence: 99%

“…13 In patients managed medically, CT allows visualization of the complete loss of dissection flap. 11 The current guideline suggests surgery for spontaneous type A AD, although it suggests medical management for IAD. 7 A study conducted among 48 patients who had IAD after a cardiac procedure, observed a 50% perioperative mortality rate following IAD after cardiac catheterization.…”

Section: Discussionmentioning

confidence: 99%

“…Hence the decision to treat medically or surgically depends on the presence of coronary flow limitation, the progression of the dissection flap toward the aortic arch, and the hemodynamic stability of the patient. 11 In contrast, Hung et al suggested passing the guide wire to the true lumen to maintain the luminal patency of the vessel sealing the dissection flap by stenting the coronary artery up to its origin. Hence, they recommend this approach for patients with Dunning class 3 (Dissection flap extends >40 mm in the ascending aorta).…”

Section: Discussionmentioning

confidence: 99%

“…13 In patients managed medically, CT allows visualization of the complete loss of dissection flap. 11…”

Section: Discussionmentioning

confidence: 99%

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A late presentation of acute iatrogenic aortic dissection following percutaneous coronary intervention: A case report

Danushka,

Jayasinghe,

Munsinghe

2023

SAGE Open Medical Case Reports

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Acute iatrogenic aortic dissection following percutaneous coronary intervention is a rare but sinister cause of post-procedure morbidity and mortality. Delayed diagnosis increases the mortality significantly. We present a case of a 52-year-old male who presented with an iatrogenic aortic dissection following percutaneous coronary intervention for an inferior ST-elevation myocardial infarction. Although the diagnosis was initially missed by conventional imaging for a period of 5 months, it was later diagnosed assisted by cardiac computed tomography. The patient underwent aortic repair with a Dacron graft and had an uneventful recovery. The case highlights the importance of early diagnosis and selection of appropriate imaging for this rare but serious iatrogenic sequel following percutaneous coronary intervention to minimize morbidity.

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Section: Discussionmentioning

confidence: 44%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…13 In patients managed medically, CT allows visualization of the complete loss of dissection flap. 11…”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

A late presentation of acute iatrogenic aortic dissection following percutaneous coronary intervention: A case report

Danushka,

Jayasinghe,

Munsinghe

2023

SAGE Open Medical Case Reports

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Watchful Waiting Strategy in Extensive Iatrogenic Aortic Dissection Complicating Percutaneous Coronary Intervention

El Jattari,

Moroni,

Scott

et al. 2024

JACC: Cardiovascular Interventions

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Immediate Recognition and Surgical Treatment of Iatrogenic Acute Type A Aortic Dissection Is Associated with Low Hospital Mortality and High Intermediate-Term Survival

Wang¹,

Liu²,

Song³

et al. 2022

Rev. Cardiovasc. Med.

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Background: To investigate short-and intermediate-term outcomes of immediate (on table) recognition and surgical treatment of iatrogenic acute type A aortic dissection (ATAD) that occurred during the course of the cardiac surgical procedures. Methods: Of 23,143 adult patients undergoing cardiac surgical procedures at our institution from January 2016 to December 2020, 21 (0.09%) suffered from intraoperative iatrogenic ATAD and underwent immediate aortic repair. Their clinical characteristics, in-hospital outcomes and follow-up results were analyzed. Results: Among the 21 patients, 13 (61.9%) suffered from hypertension, and 14 (66.7%) had a dilated ascending aorta. In-hospital mortality was 9.5%, and new onset of permanent neurologic deficit was recorded in one patient. During a median follow-up of 36.0 months, all 18 follow-up patients survived without repeated surgeries. A follow-up computed tomography (CT) examination revealed a residual false lumen in the aortic arch in 3 patients and in the descending aorta in 8, with residual false lumen perfusion in one. Conclusions: Immediate recognition and surgical repair of ATAD that developed as a complication during cardiac surgical procedures are associated with low mortality and high intermediate-term survival.

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Iatrogenic type A aortic dissection during percutaneous coronary intervention: A single-center experience

Cited by 3 publications

References 0 publications

A late presentation of acute iatrogenic aortic dissection following percutaneous coronary intervention: A case report

A late presentation of acute iatrogenic aortic dissection following percutaneous coronary intervention: A case report

Watchful Waiting Strategy in Extensive Iatrogenic Aortic Dissection Complicating Percutaneous Coronary Intervention

Immediate Recognition and Surgical Treatment of Iatrogenic Acute Type A Aortic Dissection Is Associated with Low Hospital Mortality and High Intermediate-Term Survival

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