Document Detail


Iatrogenic left main coronary artery dissection: a single-center case series.
MedLine Citation:
PMID:  21558876     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVES: The aim of the present case series was to evaluate incidence, dissection modalities, treatment and follow-up of iatrogenic left main coronary artery dissection. METHODS AND RESULTS: During a 5-year period, we identified six patients (0.056%) who fulfilled the diagnostic criteria for coronary dissection. Left main dissection was catheter induced in four cases, whereas two cases occurred as a consequence of balloon dilation or stent implantation into the proximal left anterior descending coronary artery or left circumflex coronary artery. Two patients experienced a sudden hemodynamic collapse as a consequence of a total occlusion of the left main lumen: one patient died before any rescue intervention, whereas one patient underwent successful bailout stent implantation (this patient had a periprocedural myocardial infarction). One patient had a localized asymptomatic dissection and he was treated by elective coronary artery bypass grafting because of three-vessel disease. Finally, the other three patients had an extensive dissection with associated angina but no hemodynamic collapse, and they underwent successful bailout stent implantation. At 6-month angiographic follow-up, one patient underwent a target vessel revascularization. During the entire follow-up period of 38 ± 18 months, no death, myocardial infarction or other coronary revascularization was observed. CONCLUSION: Iatrogenic left main dissection is a rare but potentially devastating complication of coronary catheterization, which can have a favorable outcome if recognized timely and treated properly.
Authors:
Salvatore Azzarelli; Francesco Amico; Michele Giacoppo; Vincenzo Argentino; Antonio Fiscella
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-5-10
Journal Detail:
Title:  Journal of cardiovascular medicine (Hagerstown, Md.)     Volume:  -     ISSN:  1558-2035     ISO Abbreviation:  -     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-5-12     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101259752     Medline TA:  J Cardiovasc Med (Hagerstown)     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Division of Cardiology, Cannizzaro Hospital, Catania, Italy.
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