JCCVS
Journal of Cardiology & Cardiovascular Surgery

Journal of Cardiology & Cardiovascular Surgery scientific, open-access, double-blind peer-reviewed journal covering a wide spectrum of topics in cardiology and cardiovascular surgery.

eISSN: 2980-1397
Creative Commons CC BY-NC-ND 4.0 International License.
EndNote Style

Online Manuscript System

Index
Case Report
Iatrogenic coronary artery dissection that occurred during postpartum coronary angiography
Abstract
Dissection of the left main coronary artery (LMCA) during diagnostic coronary angiography is a rare but catastrophic event with a poor prognosis. Immediate reperfusion with hemodynamic support should be the primary goal in patients who develop impaired blood flow distal to the acute LMCA and the first option is coronary artery by-pass grafting. We present a 37-year-old female patient in the postpartum period who was admitted to the emergency department because of chest pain and was urgently admitted to our catheterization laboratory with the diagnosis of NONSTMI. During coronary angiography, the patient developed a dissection that started with the left main coronary artery and progressed to the circumflex and left descending artery. The patient was successfully treated with emergency percutaneous intervention.

Keywords : Iatrogenic left main coronary artery dissection, postpartum period, PTCA-stenting

Download Article


1. Ozdol C, Oral D, Tutar E. Catheter-induced left main coronary arterydissection resulting in abrupt closure and cardiac arrest: successfulstenting during resuscitation. J Invasive Cardiol. 2007;19:E93-95.
2. Abdel-Karim AR, Gadiparthi C, Banerjee S, Brilakis ES. Catastrophicleft main coronary artery occlusion following diagnostic coronaryangiography: salvage by emergency left main coronary artery stenting.Acute Card Care. 2011;13:170-173.
3. Dunning DW, Kahn JK, Hawkins ET, O’Neill WW. Iatrogenic coronaryartery dissections extending into and involving the aortic root. CatheterCardiovasc Interv. 2000;51(4):387-393.
4. Lee SW, Hong MK, Kim YH, et al. Bail-out stenting for left maincoronary artery dissection during catheter-based procedure: acute andlong-term results. Clin Cardiol. 2004;27(7):393-395.
5. Awadalla H, Sabet S, El SA, Rosales O, Smalling R. Cateheter-inducedleft main dissection incidence, predisposition and therapeutic strategiesexperience from two sides of the hemisphere. J Invasive Cardiol.2005;17(4):233-236.
6. Cameron J, Aroney C, Bett J. Left main coronary artery dissectionduring coronary angioplasty or angiography treated by stent insertionwithout requirement for emergency bypass graft surgery. Aust N Z JMed. 2000;30(6):726-728.
7. James AH, Jamison MG, Biswas MS, Brancazio LR, Swamy GK,Myers ER. Acute myocardial infarction in pregnancy: a United Statespopulation-based study. Circulation. 2006;113:1564-1571.
8. Elkayam U, Jalnapurkar S, Barakkat MN, et al. Pregnancy-associatedacute myocardial infarction: a review of contemporary experience in150 cases between 2006 and 2011. Circulation. 2014;129(16):1695-1702.
9. Appleby C, Barolet A, Horlick E. Contemporary management ofpregnancy-related coronary artery dissection: A single-centreexperience and literature review. Exp Cln Cardiol. 2009; 14 (1): e8-e16.
10. Vrints CJM. Spontaneous coronary artery dissection. Heart.2010;96(10):801-808.
11. Shahzad K, Cao L, Ain QT, Waddy J, Khan N, Nekkanti R. Postpartumspontaneous dissection of the first obtuse marginal branch of the leftcircumflex coronary artery causing acute coronary syndrome: a casereport and literature review. J Medical Case Reports. 2013;7:82.
12. Unal M, Korkut AK, Kosem M, Ertunc V, Ozcan M, Caglar N. Surgicalmanagement of spontaneous coronary artery dissection. Texas HeartInstitute J. 2008;35(4):402-405.
13. De Maio SJ Jr, Kinsella SH, Silverman ME. Clinical course and long-term prognosis of spontaneous coronary artery dissection. Am JCardiol. 1989;64:471-474.
14. Hunsaker JC, O’Connor WN, Lie JT. Spontaneous coronary arterialdissection and isolated eosinophilic coronary arteritis: Sudden cardiacdeath in a patient with a limited variant of Churg-Strauss syndrome.Mayo Clin Proc. 1992;67:761-766.
15. Fernandez-Guitierrez B, Zamorano J, Battle E, et al. Coronarydissection associated with hepatitis C virus-related cryoglobulinemia.Rheumatology (Oxford) 1999;38:1299-1301.
16. Cárdenas Fernández Y, Sánchez Redonet EM, Ravelo Dopico R,Martínez García G, Valdés Carrazana E, Rodríguez Cruz LO. Disecciónespontánea de arterias coronarias en el puerperio. Presentación de caso.CorSalud. 2019;11:179-183.
17. Lee C, Saw J. Very early antepartum pregnancy-associated spontaneouscoronary artery dissection case report. Cardiovasc Diagn Ther.2018;8:512-515.
18. Cade JR, Szarf G, de Siqueira MEM, et al. Pregnancy-associatedspontaneous coronary artery dissection: insights from a case series of13 patients. Eur Heart J-Cardiovasc Imaging. 2016;18:54-61.
19. Sanghavi M, Rutherford JD. Cardiovascular physiology of pregnancy.Circulation. 2014;130:1003-1008.
20. Wang Q, Würtz P, Auro K, Mäkinen VP, et al. Metabolic profilingof pregnancy: cross-sectional and longitudinal evidence. BMC Med.2016;14:205.
21. Petrou E, Bousoula E, Boutsikou M, Iakovou I, Kolovou G, PavlidesG. Multivessel spontaneous dissection of the left coronary tree in thepostpartum period: case report and review of the literature. Eur RevMed Pharmacol Sci. 2014;18:3743-3746.
22. Jorgensen MB, Aharonian V, Mansukhani P, Mahrer PR. Spontaneouscoronary dissection: a cluster of cases with this rare finding. Am HeartJ. 1994;127:1382-1387.
23. De Maio SJ Jr, Kinsella SH, Silverman ME. Clinical course and long-term prognosis of spontaneous coronary artery dissection. Am JCardiol. 1989;64:471-474.
24. Ooi A, Lavrsen M, Monro J, Langley SM. Successful emergencysurgery on triple-vessel spontaneous coronary artery dissection. Eur JCardiothorac Surg. 2004;26(2):447-449.
25. Thistlethwaite PA, Tarazi RY, Giordano FJ, Jamieson SW. Surgicalmanagement of spontaneous left main coronary artery dissection. AnnThorac Surg. 1998;66(1):258-260.
26. Vale PR, Baron DW. Coronary artery stenting for spontaneousCoronary artery dissection: a case report and review of the literature.Cathet Cardiovasc Diagn. 1998;45(3):280-286.
27. Roig S, Gomez JA, Fiol M, et al. Spontaneous coronary artery dissectioncausing acute coronary syndrome: an early diagnosis implies a goodprognosis. Am J Emerg Med. 2003;21(7):549-551.
28. Moukarbel GV, Alam S. Spontaneous coronary artery dissection:management options in the stent era. J Invas Cardiol. 2004;16(6):333-335.
29. Wong EM, Pawsey C, Lowe HC. Evidence for “lumen sealing” withsirolimus eluting stents in the treatment of complex coronary arterydissection. Heart. 2004;90(3):e13.
30. Porras MC, Ares MA, Gill JZ. Intracoronary stenting for postpartumCoronary artery dissection. Ann Intern Med. 1998;15;128(10):873.
31. Pérez-Castellano N, García-Fernández MA, García EJ, et al. Dissectionof the aortic sinus of valsalva complicating coronary catheterization:cause, mechanism, evolution, and management. Cathet CardiovascDiagn. 1998;43:273-279.
32. Park IW, Min PK, Cho DK, et al. Successful endovascular treatmentof iatrogenic coronary artery dissection extending into the entireascending aorta. Can J Cardiol. 2008;24:857-859.
33. Sohrabi B, Kazemi B, Aslanabadi N. Percutaneous treatment ofcatheter-induced dissection of the right coronary artery and adjacentaortic wall. J Invasive Cardiol. 2007;19:E199-202.
Article available in :
Volume 1, Issue 2, 2023
Page : 33-35
https://doi.org/10.51271/JCCVS-0010
Article Information
Received : 16 Jun 2023
Accepted : 27 Jun 2023
Published : 28 Jun 2023
Corresponding Author :

Mustafa Kaan Dişyapar: Department of Cardiology, Kayseri City Hospital, Kayseri Faculty of Medicine, University of Health Sciences, Kayseri, Turkey

[email protected]
Citation : Dişyapar MK, Ergün G. Iatrogenic coronary artery dissection that occurred during postpartum coronary angiography. J Cardiol Cardiovasc Surg. 2023;1(2):33-35.

Read: -36
Download : 1312
Cited: 0
_Footer