Iatrogenic Aortocoronary Dissection: A Life Threatening Complication During Percutaneous Coronary Intervention Requiring Urgent Diagnosis and Treatment

Abstract

An elderly female patient presented with non-st elevation myocardial infarction, and stent implantation was performed into the right coronary artery (RCA). An aortic dissection, starting from the RCA ostium and extending to both right sinus valsalva and the ascending aorta (AA) occurred due to deep guiding catheter intubation during post-dilatation with non-compliant balloon. Immediately, another coronary stent was implanted in the RCA ostium and plunged into the AA by 2 mm, with a purpose of covering the entry point of the dissection. The patient underwent emergency surgery consisting of AA replacement and RCA by-pass grafting due to insufficient response for stenting. However, the patient died due to pump disfunction 10 hours after surgery.