Interventional Approach to Left Main Coronary Artery Dissection

A left main coronary artery (LMCA) iatrogenic dissection is a rare but potentially life-threatening complication of coronary angioplasty. It can range from a simple tear in the artery wall to a severe dissection, causing complete blood flow obstruction. We report the case of a 63-year-old male patie...

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Bibliographic Details
Published in:Curēus (Palo Alto, CA) CA), 2018-10, Vol.10 (10), p.e3410
Main Authors: Tabet, Rabih, Nalluri, Nikhil, Daneshvar, Farshid, Malpeso, James
Format: Article
Language:English
Subjects:
Angioplasty
Atherosclerosis
Blood clots
Cardiac/Thoracic/Vascular Surgery
Cardiology
Case reports
Catheters
Coronary vessels
Dissection
Electrocardiography
Intervention
Intubation
Medical imaging
Stents
Veins & arteries
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Summary:A left main coronary artery (LMCA) iatrogenic dissection is a rare but potentially life-threatening complication of coronary angioplasty. It can range from a simple tear in the artery wall to a severe dissection, causing complete blood flow obstruction. We report the case of a 63-year-old male patient who was presented to our catheterization laboratory following a positive stress test. An angiogram showed a proximal left anterior descending (LAD) artery tight lesion. Balloon inflation was complicated by an ostial LAD dissection that rapidly extended into the left main and the left circumflex arteries treated with angioplasty and stenting. Cardiac catheterization four days later showed a residual LMCA intimal flap that remained asymptomatic and stable. This is an interesting case of a stable LMCA dissection with the intimal flap intermittently obstructing the ostium of the left anterior descending artery. In addition, we will discuss the factors that increase the risk of coronary dissection and focus on methods to help prevent the occurrence of such complications.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.3410