Iatrogenic aortocoronary dissection: the case for immediate aortoostial stenting.
Aortoostial dissection is a serious but rare complication of coronary intervention that may require surgical aortic repair. Here we present four cases which were immediately sealed with stenting of the coronary ostium abruptly terminating spread of the aortic dissection and obviating the need for surgical repair. Long-term outcome in this small series was universally event free. Review of the literature suggests that such a strategy is frequently successful without major added risk. We propose that immediate ostial stenting (irrespective of whether the dissection starts from the ostium or further downstream in the coronary) should be strongly considered in all cases as it may prevent the need for high-risk emergent surgical aortic repair.
Carstensen
Steen
S
Royal North Shore Hospital, Australia.
Ward
Michael R
MR
D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D001019:Aortic Rupture / Q000209:etiology / Q000601:surgery*; D013504:Cardiovascular Surgical Procedures; D017023:Coronary Angiography / Q000009:adverse effects*; D054326:Coronary Sinus / Q000503:physiopathology / Q000601:surgery; D003331:Coronary Vessels / Q000473:pathology; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease; D007431:Intraoperative Complications / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015641:Radiography, Interventional / Q000009:adverse effects; D015607:Stents