- Title
- PCI in Management of Acute Type A Aortic Dissection Involving the Left Main Coronary Artery
- Creator
- Mikhail, Philopatir; Ishak, Mark; Spina, Roberto; Ford, Thomas J.; Kull, Anthony
- Relation
- JACC: Cardiovascular Interventions Vol. 16, Issue 15, p. 1939-1941
- Publisher Link
- http://dx.doi.org/10.1016/j.jcin.2023.06.024
- Publisher
- Elsevier
- Resource Type
- journal article
- Date
- 2023
- Description
- An 81-year-old woman called an ambulance after experiencing sudden-onset chest pain waking her up from sleep. An electrocardiogram performed at the scene demonstrated acute changes consistent with an anterior ST-segment elevation myocardial infarction (Figure 1A). Prehospital notification triggered an out-of-hours activation of the cardiac catheterization laboratory. Coronary angiography was performed from the right radial approach using an EBU guiding catheter, demonstrating abrupt occlusion proximally within the left anterior descending coronary artery (LAD) (Figures 1B and 1C). Despite attempting aspiration thrombectomy and balloon dilatation, there was no improvement in flow (TIMI flow grade 0). Intravascular ultrasound (IVUS) demonstrated the presence of a false lumen with extensive intramural hematoma within the left main coronary artery extending to the proximal LAD and effectively obliterating the true lumen of the vessel (Figure 2A, Video 1).
- Subject
- aortic dissection; intracoronary imaging; IVUS; PCI; STEMI
- Identifier
- http://hdl.handle.net/1959.13/1490194
- Identifier
- uon:52867
- Identifier
- ISSN:1936-8798
- Language
- eng
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