Successful Aorta-osteal Stenting after Iatrogenic Acute Type-A Aortic Dissection during Primary Percutaneous Coronary Intervention

Abstract

Background: Iatrogenic acute dissection of the ascending aorta followingcoronary angiography and percutaneous intervention is rare.This complication, if not managed urgently, can have critical results.Case Report: We present the case of a 70 year-old woman who wastreated by primary percutaneous coronary intervention (PCI) of theright coronary artery (RCA) for acute inferior myocardial infarction;however, the procedure was complicated by anterograde dissectionof the RCA with a simultaneous retrograde propagation to the proximalpart of the ascending aorta. Successful stenting of the entry pointwas able to heal the RCA and restrict the retrograde propagation tothe ascending aorta. The aortic dissection was monitored by meansof computerised tomography and the dissection repaired itself spontaneouslywithin a day.Conclusion: Treatment of the aorta coronary dissection (ACD) byurgent osteal stenting is a less invasive treatment compared with surgicaltreatment in appropriate cases. We demonstrated that immediateosteal stenting should be performed in ACD.