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Author Spotlight: Using Point-of-Care Ultrasound for Comprehensive Evaluation of the Abdominal Aorta
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Intimal windsock following type A aortic dissection: An intussusception of severe implications
Kaushalendra Rathore1, Milena M Wilke1, Bharat Khialani2
1Department of Cardiothoracic Surgery, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia.
Journal of Cardiac Surgery
|September 20, 2021
Summary
Aortic dissection can lead to coronary artery compression. Intravascular ultrasound diagnosed left main coronary artery compression, treated with a drug-eluting stent to restore blood flow.
Area of Science:
- Cardiovascular Surgery
- Interventional Cardiology
- Diagnostic Imaging
Background:
- Type A aortic dissection presents with intimointimal intussusception in the aorta.
- Aortic root replacement surgery was performed for the dissection.
Observation:
- Post-surgery, the patient experienced inferolateral myocardial infarction with troponin I leak.
- Coronary angiogram revealed a minor contrast leak at the left coronary button without luminal compromise.
Findings:
- Intravascular ultrasound identified left main coronary artery compression.
- The compression was attributed to an intramural hematoma secondary to the aortic dissection.
Implications:
- Intravascular ultrasound is crucial for diagnosing coronary artery complications in aortic dissection.
- Drug-eluting stent placement effectively relieved compression and supported the dissected coronary artery layers, improving patient outcomes.
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