Management of Iatrogenic Aortic Dissections During Percutaneous Right Coronary Artery Interventions

Area of Science:

• Cardiology
• Vascular Surgery
• Interventional Cardiology

Background:

• Iatrogenic acute aortic dissection is a rare but severe complication during percutaneous coronary interventions (PCI).
• This complication occurs in less than 0.02% of transcatheter procedures, highlighting its infrequency.
• Understanding management strategies is crucial for this life-threatening condition.

Observation:

• Three distinct patients experienced iatrogenic aortic dissection following PCI.
• All three patients presented with varying clinical characteristics.
• The dissections were identified as a complication directly resulting from the PCI procedure.

Findings:

• All three patients with iatrogenic aortic dissection underwent successful emergency open-heart surgery.
• Surgical intervention proved effective in managing these complex cases.
• The study highlights the critical role of surgical intervention in severe dissections.

Implications:

• Emergency open-heart surgery is a viable and successful treatment for iatrogenic aortic dissection post-PCI.
• A conservative management strategy is only appropriate for small, localized aortic lesions.
• These findings emphasize the importance of prompt and aggressive treatment for significant iatrogenic aortic dissections.