Subacutely progressed extensive aortic dissection complicated with catheter-induced dissection in left main coronary artery.
A 64-year-old man complaining of resting angina underwent emergent coronary angiogram and significant stenosis in the mid-left anterior descending artery was discovered. Although deployment of the drug-eluting Cypher stent relieved the stenosis, the guiding catheter accidentally induced coronary dissection in the left main coronary artery (LMCA). Then, deployment of another Cypher stent at the lesion successfully managed the complication. 20 days later, although asymptomatic, extensive aortic dissection was detected from the coronary sinus of Valsalva to the femoral artery. 64-Row multidetector computed tomography demonstrated that the dissection originated from the LMCA and retrogradely expanded to the aorta. This type of dissection is a rare complication related to coronary intervention and even in such a clinical setting, asymptomatic delayed progression of retrograde aortic dissection has not previously been reported to our knowledge.
Nomura
Tetsuya
T
Department of Cardiovascular Medicine, Nantan General Hospital, 25 Yagi-Ueno, Yagi-cho, Nantan city, Kyoto 629-0197, Japan. t2-ya@za2.so-net.ne.jp
Nakagawa
Yusuke
Y
Urakabe
Yota
Y
Naito
Daisuke
D
Enomoto
Satoko
S
Nishikawa
Susumu
S
Keira
Natsuya
N
Matsubara
Hiroaki
H
Tatsumi
Tetsuya
T
D000784:Aortic Dissection / Q000150:complications* / Q000473:pathology; D001014:Aortic Aneurysm / Q000150:complications* / Q000473:pathology; D006328:Cardiac Catheterization / Q000009:adverse effects*; D003327:Coronary Disease / Q000209:etiology*; D023921:Coronary Stenosis / Q000628:therapy; D004210:Dissection; D006801:Humans; D007049:Iatrogenic Disease; D008297:Male; D008875:Middle Aged