A Case of Coronary Artery Dissection After Aortic Replacement in Acute Type A Aortic Dissection.
10.4070/kcj.2009.39.10.428
- Author:
Sun Hee PARK
1
;
Hun Sik PARK
;
Jang Hoon LEE
;
Hyeon Min RYU
;
Jae Hee KIM
;
Won Suk CHOI
;
Kyun Hee KIM
;
Gun Jik KIM
Author Information
1. Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea. hspark@knu.ac.kr
- Publication Type:Case Report
- Keywords:
Aortic diseases;
Myocardial infarction;
Cordiovascalar surgical procedures;
Percutaneous transluminal coronary angioplasty
- MeSH:
Angioplasty, Balloon;
Angioplasty, Balloon, Coronary;
Aortic Diseases;
Arteries;
Coronary Angiography;
Coronary Vessels;
Electrocardiography;
Female;
Follow-Up Studies;
Humans;
Middle Aged;
Myocardial Infarction;
Organothiophosphorus Compounds;
Percutaneous Coronary Intervention;
Stents
- From:Korean Circulation Journal
2009;39(10):428-433
- CountryRepublic of Korea
- Language:English
-
Abstract:
A 59-year-old woman was transferred to our institution with a diagnosis of acute type A aortic dissection. During aortic replacement surgery, the dissection had not extended to the orifice of the left coronary artery. However, ST segment elevation was observed on an electrocardiogram monitor immediately postoperatively. An emergent coronary angiogram showed almost complete collapse of the lumen of the left coronary artery due to pulsatile compression of the false lumen, which was caused by extension of the aortic dissection. Percutaneous coronary intervention (PCI) was performed with placement of stents in the left anterior descending artery (LAD) and left circumflex artery. Coronary angiography and intravascular ultrasound performed 45-days after PCI showed significant instent restenosis (ISR) at the proximal portion of the LAD and residual coronary artery dissection of the diagonal branch. Repeat balloon angioplasty was performed at the site of the ISR. A follow-up coronary angiogram 8-months after the PCI showed no evidence of ISR.
