Related Experiment Video

Updated: Jun 18, 2026

Novel and Innovative Hybrid Technique for Type A Aortic Dissection
06:26

Novel and Innovative Hybrid Technique for Type A Aortic Dissection

Published on: March 28, 2025

A case of coronary artery dissection after aortic replacement in acute type a aortic dissection

Sun Hee Park1, Hun Sik Park, Jang Hoon Lee

  • 1Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea.

Korean Circulation Journal
|December 2, 2009
PubMed

Insights

Acute type A aortic dissection can compress the left coronary artery, causing ST elevation post-surgery. Percutaneous coronary intervention (PCI) successfully treated this complication, with no restenosis at 8 months.

Area of Science:

  • Cardiovascular Surgery
  • Interventional Cardiology
  • Vascular Medicine

Background:

  • Acute type A aortic dissection is a life-threatening condition requiring surgical repair.
  • Postoperative complications can include coronary artery compromise due to aortic pathology.
  • Left coronary artery involvement in aortic dissection can lead to myocardial ischemia.

Purpose of the Study:

  • To report a rare case of left coronary artery compression secondary to acute type A aortic dissection.
  • To describe the successful management of this complication using percutaneous coronary intervention (PCI).
  • To evaluate the long-term outcome of PCI in this specific clinical scenario.

Main Methods:

  • A patient with acute type A aortic dissection underwent aortic replacement surgery.
  • Postoperative ST elevation prompted emergent coronary angiography, revealing left coronary artery compression.
  • Percutaneous coronary intervention (PCI) with stenting of the left anterior descending artery (LAD) and left circumflex artery was performed.
  • Follow-up angiography and intravascular ultrasound assessed for in-stent restenosis (ISR) and residual dissection.

Main Results:

  • Emergent coronary angiography demonstrated pulsatile compression of the left coronary artery lumen by the aortic dissection's false lumen.
  • PCI successfully restored coronary blood flow, with stenting of the LAD and left circumflex artery.
  • Significant in-stent restenosis (ISR) at the proximal LAD and residual coronary artery dissection of the diagonal branch were noted at 45 days.
  • Repeat balloon angioplasty for ISR and subsequent angiography at 8 months showed no evidence of ISR.

Conclusions:

  • Left coronary artery compression by aortic dissection is a rare but critical postoperative complication.
  • PCI is an effective treatment for acute coronary compromise secondary to aortic dissection.
  • Long-term surveillance is necessary to monitor for complications such as in-stent restenosis after PCI in this context.

Keywords:
Aortic diseasesCordiovascalar surgical proceduresMyocardial infarctionPercutaneous transluminal coronary angioplasty

More Related Videos

Direct Re-implantation of Left Coronary Artery into the Aorta in Adults with Anomalous Origin of Left Coronary Artery from the Pulmonary Artery (ALCAPA)13:10

Direct Re-implantation of Left Coronary Artery into the Aorta in Adults with Anomalous Origin of Left Coronary Artery from the Pulmonary Artery (ALCAPA)

Published on: April 24, 2017

Related Concept Videos

Aneurysm III: Interprofessional Care01:26

Aneurysm III: Interprofessional Care

Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
Aortic Regurgitation I: Introduction01:15

Aortic Regurgitation I: Introduction

IntroductionAortic regurgitation is characterized by the backward flow of blood from the aorta into the left ventricle during diastole and arises from the improper closure of the aortic valve. This condition results in left ventricular volume overload and can stem from both acute and chronic etiologies, each contributing uniquely to the disease's progression and symptomatology.Acute and Chronic CausesAcute aortic regurgitation often results from events that suddenly impair the integrity of the...
Aortic Regurgitation II: Clinical Features and Diagnostic Tests01:22

Aortic Regurgitation II: Clinical Features and Diagnostic Tests

Aortic valve regurgitation (AR) occurs when the aortic valve fails to close properly, allowing blood to flow backward from the aorta into the left ventricle. This backflow can result in two distinct clinical presentations: acute and chronic AR, each characterized by its own set of symptoms and physical findings.Acute Aortic RegurgitationAcute AR presents with a sudden onset of severe symptoms. Patients typically experience profound dyspnea (shortness of breath), chest pain, and signs of left...
Aneurysm II: Clinical Manifestations and Diagnostic Studies01:21

Aneurysm II: Clinical Manifestations and Diagnostic Studies

Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
Aneurysm I: Introduction01:30

Aneurysm I: Introduction

An aortic aneurysm is a localized outpouching or dilation at a weak point in the artery wall. It may involve different parts of the aorta, such as the abdominal aorta, aortic arch, or thoracic aorta.Etiological factorsSeveral disorders are associated with aortic aneurysms.Congenital causes, such as primary connective tissue disorders like Marfan syndrome, impact the integrity and strength of connective tissues, notably affecting the aorta. Marfan syndrome is a genetic disorder that specifically...
Aortic Regurgitation III: Medical Management01:25

Aortic Regurgitation III: Medical Management

Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...