Iatrogenic Aortocoronary Dissection during Routine Coronary Angiography

[摘要] Background: Dissection of coronary artery is rare complication of cardiac catheterization and percutaneous coronary intervention. Its retrograde extension to involve the ascending aorta is even rarer. Case Report: A 62-year-old male, hypertensive, and smoker was admitted with unstable angina. Coronary angiography revealed diffuse subtotal occlusion of proximal left anterior descending artery and tubular lesion with critical stenosis of large obtuse marginal branch. When right coronary artery was cannulated and contrast was injected, there was no regurgitation of contrast from its ostium. Suddenly patient complained of severe chest pain. Contrast spillage was noted from the right coronary artery ostium which revealed huge aorto-ostial dissection extending to ascending aorta. In view of hemodynamic instability, he was urgently transferred for restorative surgery. Conclusion: Aorto-coronary is rare but catastrophic complication of cardiac catheterization which can be successfully managed with surgery.

[学科分类] 生理学

[关键词] Aorta;Chest Pain;Coronary Angiography;Coronary Vessels;Unstable Angina.