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Iatrogenic acute aortic dissection caused by intervention for spontaneous coronary artery dissection: a surgical case report

BACKGROUND: Iatrogenic acute aortic dissection (AAD) caused by cardiovascular intervention is rare. Also rare is spontaneous coronary artery dissection (SCAD), a form of acute coronary syndrome, which develops in relatively young women without coronary risk factors. We encountered type A iatrogenic...

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Autores principales: Hayashi, Yuki, Taoka, Makoto, Osaka, Shunji, Unosawa, Satoshi, Tanaka, Masashi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7526354/
https://www.ncbi.nlm.nih.gov/pubmed/32993807
http://dx.doi.org/10.1186/s13019-020-01333-6
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author Hayashi, Yuki
Taoka, Makoto
Osaka, Shunji
Unosawa, Satoshi
Tanaka, Masashi
author_facet Hayashi, Yuki
Taoka, Makoto
Osaka, Shunji
Unosawa, Satoshi
Tanaka, Masashi
author_sort Hayashi, Yuki
collection PubMed
description BACKGROUND: Iatrogenic acute aortic dissection (AAD) caused by cardiovascular intervention is rare. Also rare is spontaneous coronary artery dissection (SCAD), a form of acute coronary syndrome, which develops in relatively young women without coronary risk factors. We encountered type A iatrogenic AAD caused by an intervention for SCAD. CASE PRESENTATION: A 53-year-old woman was brought to our hospital after cardiopulmonary resuscitation. She was diagnosed with acute coronary syndrome caused by SCAD, and percutaneous coronary intervention was carried out on her distal left anterior descending artery. The dissection proceeded to the proximal left anterior descending artery and left main coronary artery trunk, so additional percutaneous coronary intervention was performed on the left circumflex artery. After the intervention, type A AAD occurred with a primary entry tear from the left main coronary artery trunk, and computed tomography showed a type A AAD of the aortic arch. We performed emergency ascending aorta replacement and coronary artery bypass grafting to the left anterior descending artery and left circumflex artery. The patient had an uneventful recovery after the operation and was discharged on postoperative day 25. CONCLUSION: To our knowledge, this is the first report of an iatrogenic AAD caused by percutaneous coronary intervention for SCAD.
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spelling pubmed-75263542020-10-01 Iatrogenic acute aortic dissection caused by intervention for spontaneous coronary artery dissection: a surgical case report Hayashi, Yuki Taoka, Makoto Osaka, Shunji Unosawa, Satoshi Tanaka, Masashi J Cardiothorac Surg Case Report BACKGROUND: Iatrogenic acute aortic dissection (AAD) caused by cardiovascular intervention is rare. Also rare is spontaneous coronary artery dissection (SCAD), a form of acute coronary syndrome, which develops in relatively young women without coronary risk factors. We encountered type A iatrogenic AAD caused by an intervention for SCAD. CASE PRESENTATION: A 53-year-old woman was brought to our hospital after cardiopulmonary resuscitation. She was diagnosed with acute coronary syndrome caused by SCAD, and percutaneous coronary intervention was carried out on her distal left anterior descending artery. The dissection proceeded to the proximal left anterior descending artery and left main coronary artery trunk, so additional percutaneous coronary intervention was performed on the left circumflex artery. After the intervention, type A AAD occurred with a primary entry tear from the left main coronary artery trunk, and computed tomography showed a type A AAD of the aortic arch. We performed emergency ascending aorta replacement and coronary artery bypass grafting to the left anterior descending artery and left circumflex artery. The patient had an uneventful recovery after the operation and was discharged on postoperative day 25. CONCLUSION: To our knowledge, this is the first report of an iatrogenic AAD caused by percutaneous coronary intervention for SCAD. BioMed Central 2020-09-29 /pmc/articles/PMC7526354/ /pubmed/32993807 http://dx.doi.org/10.1186/s13019-020-01333-6 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Case Report
Hayashi, Yuki
Taoka, Makoto
Osaka, Shunji
Unosawa, Satoshi
Tanaka, Masashi
Iatrogenic acute aortic dissection caused by intervention for spontaneous coronary artery dissection: a surgical case report
title Iatrogenic acute aortic dissection caused by intervention for spontaneous coronary artery dissection: a surgical case report
title_full Iatrogenic acute aortic dissection caused by intervention for spontaneous coronary artery dissection: a surgical case report
title_fullStr Iatrogenic acute aortic dissection caused by intervention for spontaneous coronary artery dissection: a surgical case report
title_full_unstemmed Iatrogenic acute aortic dissection caused by intervention for spontaneous coronary artery dissection: a surgical case report
title_short Iatrogenic acute aortic dissection caused by intervention for spontaneous coronary artery dissection: a surgical case report
title_sort iatrogenic acute aortic dissection caused by intervention for spontaneous coronary artery dissection: a surgical case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7526354/
https://www.ncbi.nlm.nih.gov/pubmed/32993807
http://dx.doi.org/10.1186/s13019-020-01333-6
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