Iatrogenic type A aortic dissection after catheter intervention for the left subclavian artery

Area of Science:

• Cardiology
• Vascular Surgery
• Interventional Cardiology

Background:

• Cardiac surgical procedures and catheter interventions involving the aorta carry a risk of iatrogenic aortic dissection.
• Severe stenosis of the left subclavian artery orifice is a condition sometimes requiring intervention.

Observation:

• This case report details an iatrogenic type A aortic dissection.
• The dissection occurred after elective balloon angioplasty for severe left subclavian artery orifice stenosis.
• Intramural hematoma was noted in the false lumen of the aorta, extending retrospectively to the ascending aorta.

Findings:

• Successful surgical repair of the ascending aorta was achieved 14 days post-dissection.
• The repair utilized hypothermic circulatory arrest and antegrade selective cerebral perfusion.
• No significant complications were reported following the aortic replacement surgery.

Implications:

• This case underscores the potential for iatrogenic aortic dissection during seemingly routine interventions.
• It emphasizes the importance of careful technique and awareness of potential complications in aortic interventions.
• Successful surgical management of delayed aortic dissection is feasible with advanced techniques.