title: [Coronary artery stenting as a bridge to surgery in a patient with Stanford type A acute aortic dissection involving left main trunk of coronary artery].
abstract: An 80-year-old woman was transferred to our hospital with sudden onset of chest pain. Electorocardiogram (ECG) showed ST-segment elevation of VI-V3 and aV(L) leads suggestive of acute coronary syndrome. On emergent coronary angiography, left main trunk (LMT) was externally compressed only at diastolic phase, showing acute type A aortic dissection involving the left coronary artery. A bare metal stent was promptly implanted to LMT to restore coronary blood flow because of her hemodynamic instability. Soon after this procedure, ischemic changes disappeared on ECG and she was transferred to the operating room in stable hemodynamic condition without chest discomfort. Emergent graft replacement of ascending aorta and proximal portion of transverse arch was successfully performed. As the bare metal stent had been properly implanted at the LMT and weaning from cardiopulmonary bypass was uneventful regardless of decreased left ventricular wall motion of anteroseptal area, coronary artery bypass grafting was not performed. A "bridge to surgery" use of coronary stenting was very effective as a life saving procedure for the patients with acute aortic dissection involving the left coronary artery.
authors.affiliation: Department of Cardiovascular Surgery, JA Onomichi Genaral Hospital, Onomichi, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Hamamoto
authors.forename: Tomokuni
authors.initials: T
authors.lastname: Furukawa
mesh_terms: D000369:Aged, 80 and over; D000784:Aortic Dissection / Q000150:complications / Q000209:etiology / Q000601:surgery*; D001014:Aortic Aneurysm / Q000150:complications / Q000601:surgery*; D023921:Coronary Stenosis / Q000628:therapy*; D005260:Female; D006801:Humans; D015607:Stents