scholarly journals Spontaneous Early Resolution of an Iatrogenic Type A Aortic Dissection Following Coronary Angiography

Aorta ◽  
2018 ◽  
Vol 06 (06) ◽  
pp. 142-144
Author(s):  
Yavuzer Koza ◽  
Uğur Kaya ◽  
Hakan Taş ◽  
Enise Koza
Keyword(s):  
Coronary Angiography ◽  
Aortic Dissection ◽  
Medical Therapy ◽  
Ascending Aorta ◽  
Artery Dissection ◽  
Coronary Artery Dissection ◽  
Type A Aortic Dissection ◽  
Hemodynamic Compromise ◽  
Iatrogenic Aortic Dissection ◽  
St Elevation

AbstractA 74-year-old man was admitted with the diagnosis of non–ST-elevation myocardial infarction. During right coronary angiography, a coronary artery dissection extending into the proximal ascending aorta was noticed without hemodynamic compromise. Immediate computed tomography angiography showed no evidence of dissection in the ascending aorta. The patient remained hemodynamically stable with medical therapy alone. This case report highlights the importance of medical therapy in patients with uncomplicated iatrogenic aortic dissection.

Coronary dissection with ST elevation myocardial infarction responding to thrombolytic and conservative therapy alone

2020 ◽  
Vol 16 (4) ◽  
pp. 271-274
Author(s):  
Morteza Safi ◽  
AliReza Serati ◽  
Sepideh Emami ◽  
Mohammad Reza Movahed
Keyword(s):  
Myocardial Infarction ◽  
Clinical Judgment ◽  
Conservative Therapy ◽  
Coronary Intervention ◽  
Artery Dissection ◽  
Coronary Artery Dissection ◽  
Anterior Myocardial Infarction ◽  
Hemodynamic Compromise ◽  
Major Coronary Artery ◽  
St Elevation

In this report, we describe a case of spontaneous coronary dissection involving left anterior descending artery presenting with acute anterior myocardial infarction successfully treated with thrombolytic and conservative therapy with a suggestion that spontaneous resolution of thrombus occurred before coronary intervention could be performed. As we did not have initial angiogram due to patient’s refusal, this assumption is speculative. However, this case suggests that dissections may heal spontaneously and could be treated with conservative approach in selected cases based on best clinical judgment. It is important to realize that the clinical course of a major coronary artery dissection remains unpredictable. Therefore, cardiologists should always treat each case individually and consider coronary interventions if conservative treatment is not leading to resolution of ST elevation or in patients with hemodynamic compromise. This case is followed by discussion about conservative versus invasive management of spontaneous coronary dissections.

scholarly journals A Case of Coronary Artery Dissection After Aortic Replacement in Acute Type A Aortic Dissection

2009 ◽  
Vol 39 (10) ◽  
pp. 428 ◽  
Author(s):  
Sun Hee Park ◽  
Hun Sik Park ◽  
Jang Hoon Lee ◽  
Hyeon Min Ryu ◽  
Jae Hee Kim ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Aortic Dissection ◽  
Type A ◽  
Artery Dissection ◽  
Acute Type ◽  
Coronary Artery Dissection ◽  
Type A Aortic Dissection ◽  
Aortic Replacement

scholarly journals Non-surgical treatment of a coronarography-induced iatrogenic aortic dissection

2021 ◽  
Author(s):  
nicolas d'ostrevy ◽  
lucie cassagnes ◽  
nicolas Durel ◽  
Lionel Camilleri
Keyword(s):  
Surgical Treatment ◽  
Aortic Dissection ◽  
Ascending Aorta ◽  
Antithrombotic Treatment ◽  
Type A Aortic Dissection ◽  
Coronary Catheterization ◽  
Iatrogenic Aortic Dissection ◽  
Risk Balance ◽  
Management Recommendations ◽  
Non Surgical Treatment

Coronary dissection is an extremely rare but known complication of coronary catheterization and angioplasty. Due to its rarity, there are no management recommendations. However, surgery immediately after an endovascular procedure is frequently carried out under major antithrombotic treatment. The surgery and the postoperative consequences are therefore very complex. We report here the documented case of a type A aortic dissection after coronary catheterization. Despite extension to the entire ascending aorta which indicated surgical management, the benefit-risk balance argued for armed surveillance to avoid surgery under antiplatelets drugs without known antidote. We believe this case should lead us to systematically weigh the data before considering that any iatrogenic dissection of Dunning class 3 should be operated.

scholarly journals Defining the Cause of Postpartum Myocardial Infarction – Another Use for Optical Coherence Tomography

2020 ◽  
Author(s):  
Abdullah Alenezi ◽  
Jadan Alsaddah ◽  
Ossama Maadarani
Keyword(s):  
Myocardial Infarction ◽  
Optical Coherence Tomography ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Artery Dissection ◽  
Optical Coherence ◽  
Artery Wall ◽  
Coronary Artery Dissection ◽  
Middle Segment ◽  
St Elevation

Chest pain in a young postpartum female can have many causes; however, when associated with ST elevation on ECG, spontaneous coronary artery dissection (SCAD) should be high on the list. Coronary angiography remains the first step in delineating the coronary lesion in suspected cases of SCAD and optical coherence tomography (OCT) can be crucial when the angiographic appearance remains uncertain. We present a case of a young postpartum female with ST elevation myocardial infarction (STEMI). Coronary angiography revealed a dilated part of the middle segment of the left anterior descending (LAD) artery while intramural haematoma (IMH) of the coronary artery wall was found on OCT, which confirmed the clinically suspected diagnosis of SCAD.

scholarly journals Surgical Management of Type A Aortic Dissection After Percutaneous Coronary Intervention in a Patient with Acute Myocardial Infarction Due to a Spontaneous Coronary Artery Dissection

2021 ◽  
Author(s):  
Athanasia Makrygianni ◽  
Filippos - Paschalis Rorris ◽  
Lydia Kokotsaki ◽  
Konstantinos Velissarios ◽  
Mohammad Salmasi ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Aortic Dissection ◽  
Coronary Intervention ◽  
Artery Dissection ◽  
Spontaneous Coronary Artery Dissection ◽  
Coronary Artery Dissection ◽  
Type A Aortic Dissection ◽  
Percutaneous Coronary

Type A aortic dissection after percutaneous coronary intervention is a rare and life-threatening situation. The reported incidence ranges from 0,02% to 0,6% of all diagnostic and interventional percutaneous procedures. We describe a case of aortic dissection after percutaneous coronary intervention in a patient with acute myocardial infarction from spontaneous coronary artery dissection. The patient was initially treated with primary percutaneous coronary intervention of the affected left coronary artery branches and left main coronary artery. Conservative management for the aortic dissection proved inadequate due to increasing diameter of the false lumen and the patient was referred to our cardiovascular unit for definite surgical management.

Cannulating a Dissecting Aorta Using Ultrasound-Epiaortic and Transesophageal Guidance

2011 ◽  
Vol 14 (6) ◽  
pp. 373 ◽  
Author(s):  
Saina Attaran ◽  
Maria Safar ◽  
Hesham Zayed Saleh ◽  
Mark Field ◽  
Manoj Kuduvalli ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Aortic Dissection ◽  
Acute Aortic Dissection ◽  
False Lumen ◽  
Type A ◽  
Ascending Aorta ◽  
Type A Aortic Dissection ◽  
Complete Rupture

<p>Management of acute Stanford type A aortic dissection remains a major surgical challenge. Directly cannulating the ascending aorta provides a rapid establishment of cardiopulmonary bypass but consists of risks such as complete rupture of the aorta, false lumen cannulation, subsequent malperfusion and propagation of the dissection.</p><p>We describe a technique of cannulating the ascending aorta in patients with acute aortic dissection that can be performed rapidly in hemodynamically unstable patients under ultrasound-epiaortic and transesophageal (TEE) guidance.</p>

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