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Journal of Medical Case Reports

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Open Access 01-12-2022 | Angiography | Case report

Delayed percutaneous coronary intervention for an extensive iatrogenic left main coronary artery dissection: a case report

Authors: Charalampos Varlamos, Efthymia Varytimiadi, Despoina-Rafailia Benetou, Dimitrios Alexopoulos

Published in: Journal of Medical Case Reports | Issue 1/2022

Abstract

Background

Iatrogenic left main coronary artery dissection is a rare but serious complication that can occur both during diagnostic coronary angiography and percutaneous coronary intervention. Early diagnosis and choice of optimal management are of crucial importance for patient’s outcome while representing a challenge for clinicians.

Case presentation

We present a case of iatrogenic left main coronary artery dissection occurring during diagnostic coronary angiography in a 53-year-old Greek woman with a history of coronary artery bypass grafting. Although dissection was greatly extending to mid left anterior descending artery, delayed percutaneous coronary intervention was successfully performed by carefully wiring the true lumen.

Conclusions

Delayed percutaneous coronary intervention, performed 25 days following the index event, proved to be a feasible and effective strategy for treating a widely extended left main coronary artery iatrogenic dissection.

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Eshtehardi P, Adorjan P, Togni M, et al. Iatrogenic left main coronary artery dissection: incidence, classification, management, and long-term follow-up. Am Heart J. 2010;159(6):1147–53. https://doi.org/10.1016/j.ahj.2010.03.012.CrossRef

Malik N, Raphael CE, Gershlick AH. Coronary dissection. In: Lindsay A, Chitkara K, Di Mario C, editors. Complications of percutaneous coronary intervention. London: Springer; 2016. https://doi.org/10.1007/978-1-4471-4959-0_17.CrossRef

Hiraide T, Sawano M, Shiraishi Y, et al. Impact of catheter-induced iatrogenic coronary artery dissection with or without postprocedural flow impairment: a report from a Japanese multicenter percutaneous coronary intervention registry. PLoS ONE. 2018;13(9): e0204333. https://doi.org/10.1371/journal.pone.0204333.CrossRef

Baghdasaryan D, Nazaryan A. Iatrogenic right coronary artery dissection caused by diagnostic transradial cardiac catheterization. Clin Case Rep. 2017;5(8):1234–7. https://doi.org/10.1002/ccr3.1047.CrossRef

Ramasamy A, Bajaj R, Jones DA, et al. Iatrogenic catheter-induced ostial coronary artery dissections: prevalence, management, and mortality from a cohort of 55,968 patients over 10 years. Catheter Cardiovasc Interv. 2020. https://doi.org/10.1002/ccd.29382.CrossRef

Onsea K, Kayaert P, Desmet W, Dubois CL. Iatrogenic left main coronary artery dissection. Neth Heart J. 2011;19(4):192–5. https://doi.org/10.1007/s12471-011-0089-1.CrossRef

Cheng CI, Wu CJ, Hsieh YK, et al. Percutaneous coronary intervention for iatrogenic left main coronary artery dissection. Int J Cardiol. 2008;126(2):177–82. https://doi.org/10.1016/j.ijcard.2007.03.125.CrossRef

Harding SA, Fairley SL. Catheter-induced coronary dissection: keep calm and don’t inject∗. J Am Coll Cardiol Case Rep. 2019;1(2):113–5. https://doi.org/10.1016/j.jaccas.2019.07.002.CrossRef

Bouisset F, Gerbaud E, Bataille V, et al. Percutaneous myocardial revascularization in late-presenting patients with STEMI. J Am Coll Cardiol. 2021;78(13):1291–305. https://doi.org/10.1016/j.jacc.2021.07.039.CrossRef

10.

Mohammed AA, Yang A, Shao K, et al. Patients with left main coronary artery vasospasm inadvertently undergoing coronary artery bypass grafting surgery. J Am Coll Cardiol. 2013;61(8):899–900. https://doi.org/10.1016/j.jacc.2012.10.048.CrossRef

Title: Delayed percutaneous coronary intervention for an extensive iatrogenic left main coronary artery dissection: a case report
Authors: Charalampos Varlamos
Efthymia Varytimiadi
Despoina-Rafailia Benetou
Dimitrios Alexopoulos
Publication date: 01-12-2022
Publisher: BioMed Central
Keywords: Angiography
CABG
CABG
Published in: Journal of Medical Case Reports / Issue 1/2022
Electronic ISSN: 1752-1947
DOI: https://doi.org/10.1186/s13256-022-03677-0

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Springer Medicine

Delayed percutaneous coronary intervention for an extensive iatrogenic left main coronary artery dissection: a case report

Abstract

Background

Case presentation

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Case presentation

Conclusions

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