Emergency valve preserving ascending aorta replacement following iatrogenic right coronary artery dissection: A life-saving procedure

J Card Surg. 2020 Aug;35(8):2059-2063. doi: 10.1111/jocs.14772. Epub 2020 Jul 11.

Abstract

Iatrogenic aortocoronary dissection is a rare but potentially fatal complication of coronary catheterizations. Although the incidence is comparatively low, dissection often leads to procedure failure with increased risk of myocardial infarction and death. Iatrogenic aortocoronary dissection is principally caused by disruption of intima at the ostia of the right or left coronary artery during interventional procedures and appears as luminal filling defects, the persistence of contrast or intimal tear outside the coronary lumen. We present a case of right coronary artery dissection leading to type-A aortic dissection suffered during diagnostic coronary catheterization. This required emergency supracoronary replacement of the ascending aorta with an aortic interposition tube graft and venous grafts to coronary arteries.

Keywords: aortic dissection; coronary catheterization; right coronary artery.

Publication types

  • Case Reports

MeSH terms

  • Aorta / surgery*
  • Aortic Dissection / etiology*
  • Aortic Dissection / surgery*
  • Aortic Valve*
  • Blood Vessel Prosthesis Implantation / methods*
  • Cardiac Catheterization / adverse effects*
  • Coronary Vessels
  • Female
  • Humans
  • Iatrogenic Disease*
  • Middle Aged
  • Organ Sparing Treatments / methods*