| CASE REPORT |
|
| Year : 2019 | Volume
: 29
| Issue : 2 | Page : 62-64 |
|
|
The usefulness of a multimodality approach in a case of subtle iatrogenic aortic dissection: Sometimes is better to look and wait
Ignazio Salamone1, Maria Ludovica Carerj1, Ugo Barbaro1, Vittorio Virga2, Concetta Zito2, Antonio Bracco2, Alfredo Blandino1, Sergio Racchiusa1
1 Department of Biomedical Sciences and Morphological and Functional Imaging, University of Messina, Policlinico “G. Martino,” Messina, Italy
2 Department of Clinical and Experimental Medicine, University of Messina, Policlinico “G. Martino,” Messina, Italy
Correspondence Address:
Ugo Barbaro
Consolare Pompea Street, 13, Messina 98168
Italy
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/jcecho.jcecho_13_19
|
|
|
We report a rare case of iatrogenic right coronary artery (RCA) dissection complicated by a retrograde subtle aortic dissection, which occurred during a primary percutaneous transluminal coronary angioplasty (PTCA). A 65-year-old female, with acute anterior ST-elevation myocardial infarction (STEMI), promptly underwent primary PTCA in the left anterior descending artery. After 5 h, the patient's condition becomes worse with recurrence of chest pain and new electrocardiogram modifications suggestive of inferior STEMI. A second coronary angiography revealed a spiral dissection extending from the ostium to the medium tract of the RCA. At the same time, a contrast media extravasation due to coronary ostium fissure occurred. Coronary stents were implanted from the medium tract of the right coronary to the ostium, to promptly arrest the active bleeding and to treat the dissection. After cardiosurgical advice, the patient was referred to the radiology department, where she underwent computed tomography angiography (CTA), which showed a small hematoma in the anterior wall of the ascending aorta. The stable clinical conditions of the patient suggested a conservative therapeutic approach. During the following 6 weeks CTA and transesophageal echocardiography were performed to rule out any other complication, and the patient was fortunately discharged with almost complete resolution of the hematoma.
|
|
|
|
| [FULL TEXT] [PDF]* |
|
 |
|
