Type A aortic dissection during therapeutic coronary intervention in acute coronary syndrome: case report

Abstract

Iatrogenic aortic dissection during coronary interventions is a rare complication and has heterogeneous management in the reviewed literature. We report a case of acute aortic syndrome of traumatic etiology, during a percutaneous coronary procedure, with its management, intra-hospital evolution, and one-year follow-up. A 65-year-old female who, during a percutaneous coronary intervention, presented an endothelium trauma of the left main artery's aorta-ostial transition by the tip of the guide catheter, leading to aortic dissection and occlusion of the left main artery with hemodynamic deterioration of the patient. The left main artery's flow was restored with drug-eluting stent implantation leading to a successful sealing of the false lumen with consequent hemodynamic stabilization. Immediate post-procedure transthoracic echocardiography showed a competent aortic valve. The patient evolved favorably and remains asymptomatic after one year.