title: [The worst complication during percutaneous coronary intervention: left main coronary artery dissection].
abstract: Although rare, left main coronary artery dissection is a cause of periprocedural mortality during percutaneous coronary interventions. We report a case of iatrogenic dissection of the left main coronary artery causing cardiogenic shock, treated by extracorporeal membrane oxygenation (ECMO) support and later on by multiple balloon angioplasty and drug-eluting stent deployment, due to clinical worsening despite patent left coronary arteries with preserved good TIMI flow grade. We also reviewed the management strategies of this complication reported in the literature.
authors.affiliation: Dipartimento di Scienze Cardiologiche, Toraciche e Vascolari, Università degli Studi, Padova.
authors.forename: Filippo
authors.initials: F
authors.lastname: Zilio
authors.affiliation: Dipartimento di Scienze Cardiologiche, Toraciche e Vascolari, Università degli Studi, Padova.
authors.forename: Massimo
authors.initials: M
authors.lastname: Napodano
authors.affiliation: Dipartimento di Scienze Cardiologiche, Toraciche e Vascolari, Università degli Studi, Padova.
authors.forename: Marny
authors.initials: M
authors.lastname: Fedrigo
authors.affiliation: Dipartimento di Scienze Cardiologiche, Toraciche e Vascolari, Università degli Studi, Padova.
authors.forename: Annalisa
authors.initials: A
authors.lastname: Angelini
authors.affiliation: Dipartimento di Scienze Cardiologiche, Toraciche e Vascolari, Università degli Studi, Padova.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Tarantini
mesh_terms: D000784:Aortic Dissection / Q000209:etiology* / Q000628:therapy; D015906:Angioplasty, Balloon, Coronary; D009202:Cardiomyopathies / Q000000981:diagnostic imaging; D003323:Coronary Aneurysm / Q000209:etiology* / Q000628:therapy; D003324:Coronary Artery Disease / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D003326:Coronary Circulation; D018450:Disease Progression; D054855:Drug-Eluting Stents; D015199:Extracorporeal Membrane Oxygenation; D017809:Fatal Outcome; D005260:Female; D006353:Heart-Assist Devices; D006406:Hematoma / Q000000981:diagnostic imaging; D006801:Humans; D020300:Intracranial Hemorrhages / Q000209:etiology; D007431:Intraoperative Complications / Q000209:etiology* / Q000628:therapy; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects*; D011859:Radiography