Closure of the left main trunk of the coronary artery and total arch replacement in acute type A dissection during coronary angiography.
A 64-year-old woman was complicated with acute type A dissection arising from the left main trunk during percutaneous coronary angiography. As the extent of dissection was localized in the ascending aorta, a bare-metal stent was inserted into the left main trunk to cover the entry of dissection. Two days after an angiography, the patient's hemodynamic status suddenly deteriorated. A computed tomographic scan showed expansion of a thrombosed false lumen severely compressing the true lumen. Emergency total arch replacement was performed, combined with ligation of the left main trunk and coronary artery bypass grafting. The patient recovered well without residual dissection in the sinus of Valsalva.
Takahashi
Yosuke
Y
Department of Cardiovascular Surgery, Fukui Cardiovascular Center, Fukui, Japan. ysk@msic.med.osaka-cu.ac.jp
Tsutsumi
Yasushi
Y
Monta
Osamu
O
Kohshi
Keitaro
K
Sakamoto
Tomohiko
T
Ohashi
Hirokazu
H
D000784:Aortic Dissection / Q000601:surgery*; D001013:Aorta, Thoracic / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D017023:Coronary Angiography / Q000009:adverse effects*; D001026:Coronary Artery Bypass; D005260:Female; D006325:Heart Atria / Q000601:surgery; D006338:Heart Neoplasms / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D007049:Iatrogenic Disease; D008875:Middle Aged; D009232:Myxoma / Q000175:diagnosis / Q000601:surgery; D012086:Reoperation; D012850:Sinus of Valsalva; D015607:Stents; D014680:Veins / Q000637:transplantation