A case of coronary artery dissection after aortic replacement in acute type a aortic dissection.
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.
Park
Sun Hee
SH
Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea.
Park
Hun Sik
HS
Lee
Jang Hoon
JH
Ryu
Hyeon Min
HM
Kim
Jae Hee
JH
Choi
Won Suk
WS
Kim
Kyun Hee
KH
Kim
Gun Jik
GJ