Successful percutaneous coronary intervention in a case of acute aortic dissection complicated with malperfusion of the left main coronary artery after replacement of the ascending aorta.

General Thoracic and Cardiovascular Surgery
Daijiro HoriHideo Adachi

Abstract

A 75-year-old female was admitted to our hospital with sudden back pain and right leg ischemia. Computed tomography showed acute type A aortic dissection with the occlusion of the right common iliac artery. The patient was treated with ascending aorta replacement and femoro-femoral bypass. Three hours after the operation, the patient went into a sudden shock. Electrocardiogram showed ventricular tachycardia and ventricular fibrillation. Percutaneous cardio-pulmonary support was administered and coronary arteriogram (CAG) was proceeded for evaluation of the coronary arteries. Although CAG revealed normal coronary arteries, intravascular ultrasound showed mobile intimal flap at left main coronary artery trunk, suggesting dissection of the coronary artery. Percutaneous coronary intervention of the left main coronary artery trunk was performed. The patient recovered from shock and was discharged from the hospital without any major complication.

References

Sep 28, 1999·Cardiovascular Surgery : Official Journal of the International Society for Cardiovascular Surgery·P M Pêgo-FernandesA D Jatene
Mar 10, 2001·The Journal of Thoracic and Cardiovascular Surgery·E NeriC Sassi
Nov 7, 2003·The Annals of Thoracic Surgery·Koji KawahitoTakashi Ino
Jan 24, 2007·Journal of Cardiac Surgery·Ercan ErenCevat Yakut

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Citations

Apr 8, 2017·General Thoracic and Cardiovascular Surgery·Mototsugu TamakiYasuhide Okawa

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