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Published on: April 17, 2020
False lumen stent placement during iatrogenic coronary dissection
M Paz Suarez-Mier1, Jose L Merino
1Servicio de Histopatología, Instituto Nacional de Toxicología y Ciencias Forenses, Madrid, Spain. mpsuarezmier@gmail.com
Summary
Iatrogenic left main coronary trunk dissection during angiography led to acute coronary syndrome and cardiac arrest. Despite stent placement, the patient died, highlighting procedural risks.
Area of Science:
- Cardiology
- Interventional Cardiology
- Vascular Surgery
Background:
- Acute coronary syndrome (ACS) without ST-segment elevation is a common presentation requiring invasive evaluation.
- Coronary angiography is a standard diagnostic tool for ACS, but carries inherent risks.
- Iatrogenic complications, though rare, can have severe consequences.
Observation:
- A 38-year-old woman presented with ACS without ST-segment elevation.
- Coronary angiography revealed iatrogenic dissection and acute occlusion of the left main coronary trunk (LCT).
- The patient experienced hemodynamic collapse, requiring cardiopulmonary resuscitation (CPR) and stent placement in the LCT and left anterior descending coronary (LAD).
Findings:
- Despite prompt intervention with drug-eluting stents, the patient succumbed to hyperacute myocardial infarction.
- Autopsy confirmed LCT and LAD dissection with stents malpositioned in the false lumen.
- This case illustrates a fatal outcome from a rare iatrogenic complication during coronary angiography.
Implications:
- Emphasizes the critical need for meticulous technique and careful patient selection in interventional cardiology procedures.
- Highlights the potential for catastrophic outcomes from iatrogenic coronary artery dissection.
- Underscores the importance of recognizing and managing rare but severe complications of invasive cardiac procedures.
