Document Detail


Unusual complication of retrograde dissection to the coronary sinus of valsalva during percutaneous revascularization: a single-center experience and literature review.
MedLine Citation:
PMID:  11171728     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: While coronary dissection, which is one of the most frequently occurring complications during interventional procedures, has various forms, extensive coronary dissection retrograde to the coronary sinus of Valsalva (CSV) is very rarely observed. METHODS AND RESULTS: Within the last 5 years, we retrospectively reviewed our experience with 4,700 consecutive patients who underwent angioplasty procedures, 7 of whom (0.15%) developed extensive coronary dissection retrograde to the CSV. Six of the seven patients developed retrograde dissection of the right CSV during angioplasty to the right coronary artery. One of the seven patents developed retrograde dissection of the left CSV during angioplasty to the left anterior descending artery. Retrograde dissection, which extended to the ascending aorta in two patients, was observed by transthoracic echocardiography and surgical findings, respectively. Five patients were successfully treated by coronary stenting. However, this complication caused four patients to have acute myocardial infarctions, resulting in emergency surgery for one patient and in-hospital death for another. CONCLUSIONS: Our experience increased our understanding of this very rare complication. However, this complication may be life threatening, and patients in this clinical setting may have a potential risk for acute myocardial infarction, emergency surgery, or even sudden cardiac death. Therefore, it is important to learn how to promptly diagnose and manage this complication.
Authors:
H K Yip; C J Wu; K H Yeh; C L Hang; C Y Fang; K Y Hsieh; M Fu
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Chest     Volume:  119     ISSN:  0012-3692     ISO Abbreviation:  Chest     Publication Date:  2001 Feb 
Date Detail:
Created Date:  2001-02-22     Completed Date:  2001-04-05     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  United States    
Other Details:
Languages:  eng     Pagination:  493-501     Citation Subset:  AIM; IM    
Affiliation:
Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung, Taiwan, Republic of China.
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MeSH Terms
Descriptor/Qualifier:
Aneurysm, Dissecting / etiology*
Angioplasty, Transluminal, Percutaneous Coronary / adverse effects*
Aortic Aneurysm / etiology*
Coronary Angiography
Female
Heart Catheterization / adverse effects
Humans
Male
Retrospective Studies
Sinus of Valsalva*
Stents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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