scholarly journals Percutaneous Coronary Intervention for Iatrogenic Right Coronary Artery Dissection Post Bentall Procedure: A Case Report and Minireview

2018 ◽  
Vol 2018 ◽  
pp. 1-6
Author(s):  
Sameer Saleem ◽  
Mubbasher A. Syed ◽  
Khalid Changal ◽  
Abdulelah Nuqali ◽  
Mujeeb Sheikh
Keyword(s):  
Coronary Artery ◽  
Right Coronary Artery ◽  
Clinical Status ◽  
Coronary Intervention ◽  
Percutaneous Treatment ◽  
Artery Dissection ◽  
Published Data ◽  
Special Focus ◽  
Coronary Artery Dissection ◽  
Bentall Procedure

Iatrogenic coronary artery dissection is a potentially life-threatening complication of cardiovascular interventions. The optimal management of iatrogenic coronary artery dissection is not clear; however, both conservative management and percutaneous or surgical revascularization have been performed depending on the patient’s clinical status and the extent of dissection. We present the first reported case of right coronary artery dissection after Bentall procedure performed for ascending aortic aneurysm. Urgent percutaneous intervention using adjunctive coronary imaging was performed with excellent clinical recovery. In this article, we highlight coronary artery dissection after Bentall procedure as a possible complication, provide an insight into various options in its management, and review published data on iatrogenic coronary artery dissection. We also discuss the challenges in percutaneous treatment of coronary artery dissection with special focus on intracoronary imaging for accurate diagnosis and guidance in the management of this complex lesion.

scholarly journals Iatrogenic Dissection of The Right Coronary Artery and The Ascending Aorta Secondary to Percutaneous Coronary Intervention: A Case Report

2020 ◽  
Vol 23 (3) ◽  
pp. E366-E369
Author(s):  
Changjiang Yu ◽  
Fan He ◽  
Huaidong Chen ◽  
Jianmao Hong ◽  
Ximing Qian
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Right Coronary Artery ◽  
Coronary Intervention ◽  
Ascending Aorta ◽  
Artery Dissection ◽  
Coronary Artery Dissection ◽  
Percutaneous Coronary ◽  
Aorta Replacement ◽  
The Right

Iatrogenic dissections of coronary artery and aorta is a rare and potentially fatal event, often following percutaneous coronary intervention (PCI). The prognosis of patients often depends on early accurate diagnosis and timely and effective treatment. There are no definite guidelines for the treatment of acute coronary artery dissection caused by PCI. Here, we report a 50-year-old patient with iatrogenic dissection of the right coronary artery and type A aortic dissection who underwent PCI for chest pain. We performed emergency surgery of right coronary artery ostium repair, aortic valvoplasty, ascending aorta replacement, and aortic arch descending stent implantation for the patient. The operation went smoothly, and the patient successfully was discharged two weeks after the operation.

scholarly journals Spontaneous Dissection of Right Coronary Artery Manifested with Acute Myocardial Infarction

2010 ◽  
Vol 4 (1) ◽  
pp. 178-180 ◽  
Author(s):  
Stelios Paraskevaidis ◽  
Efstratios K Theofilogiannakos ◽  
Yiannis S Chatzizisis ◽  
Lilian Mantziari ◽  
Fotis Economou ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery ◽  
Right Coronary Artery ◽  
Coronary Intervention ◽  
Artery Dissection ◽  
Coronary Artery Dissection ◽  
Percutaneous Coronary ◽  
Coronary Events ◽  
Traditional Risk Factors ◽  
Artery Disease

Spontaneous coronary artery dissection is a rare cause of acute ischemic coronary events and sudden cardiac death. It usually occurs in young women without traditional risk factors for coronary artery disease during pregnancy or postpartum period. However, it has also been reported in patients with atherosclerotic coronary disease. We present a case of spontaneous right coronary artery dissection in a 48-year male with recent myocardial infarction and previous percutaneous coronary intervention.

scholarly journals Successful treatment of a spontaneous right coronary artery dissection with a 4-mm diameter cutting balloon: a case report

2019 ◽  
Vol 3 (4) ◽  
pp. 1-6 ◽  
Author(s):  
Harish Sharma ◽  
Vincenzo Vetrugno ◽  
Sohail Q Khan
Keyword(s):  
Coronary Artery ◽  
Right Coronary Artery ◽  
Case Reports ◽  
Small Diameter ◽  
Coronary Intervention ◽  
Artery Dissection ◽  
Haemodynamic Instability ◽  
Intramural Haematoma ◽  
Coronary Artery Dissection ◽  
Cutting Balloon

Abstract Background Guidelines recommend conservative management for a spontaneous coronary artery dissection (SCAD) in the absence of ongoing ischaemia, haemodynamic instability, or left main dissection. Conventional percutaneous coronary intervention methods for SCAD are associated with an unfavourable prognosis due to difficulties wiring the lesion, dissection propagation, and potential ‘milking’ of the intramural haematoma along the vessel or into other vessels. These factors promote implantation of multiple stents which are often undersized, increasing the risk of in-stent restenosis significantly. There have been several case reports demonstrating the novel use of small diameter cutting balloons in the left anterior descending artery system. Here, we describe the successful use of a larger 4 mm cutting balloon to treat a spontaneous right coronary artery (RCA) dissection. Case summary A 53-year-old woman with troponin negative chest pain and was diagnosed with unstable angina due to ischaemic electrocardiographic features. Coronary angiography revealed a tight discrete lesion in the RCA. Intravascular imaging confirmed SCAD and a 4 mm cutting balloon was used to dissect the tunica intima to allow complete resorption of the intramural haematoma and resolution of symptoms. Discussion This case demonstrates the safe use of a larger 4 mm cutting balloon to treat an RCA SCAD, resulting in complete resolution of the haematoma.

scholarly journals Catheter Induced Dissection of Right Coronary Artery during Percutaneous Coronary Intervention: A Case Report

2020 ◽  
pp. 34-37
Author(s):  
Atul Kaushik ◽  
Surendra Patel ◽  
Jai Bharat Sharma ◽  
Rahul Choudhary
Keyword(s):  
Coronary Artery ◽  
Right Coronary Artery ◽  
Coronary Intervention ◽  
Artery Dissection ◽  
Inferior Wall ◽  
Coronary Artery Dissection ◽  
Iatrogenic Complications ◽  
Percutaneous Coronary ◽  
Life Threatening ◽  
The Right

Iatrogenic coronary artery dissections are rare but life-threatening complications which may have different etiologies. These complications should be recognized promptly and must be managed to avoid mortality. We are reporting a case of a 57-year old man who presented to us with acute inferior wall myocardial infarction and developed proximal right coronary dissection while undergoing percutaneous angioplasty through trans radial approach and was managed successfully with immediate rewiring and stenting of the right coronary artery. The patient remained asymptomatic at regular follow up. Coronary angiogram and angioplasty are both invasive procedures which may at times result in iatrogenic complications like catheter induced coronary dissection. Coronary artery dissection may prove fatal at times and should be dealt with immediately with appropriate intervention.

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