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Right Ventricular Failure Secondary to Right Coronary Artery Dissection Complicated by Impella Malfunction

Keaton Wieschhaus1, Navya Vadlamudi2, Keerthi Sajja3

  • 1Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.

JACC. Case Reports
|August 29, 2025
PubMed

Insights

Iatrogenic coronary artery dissection during angiography is rare but serious. Prompt stenting and circulatory support can manage complications like cardiogenic shock and cardiac arrest.

Area of Science:

  • Cardiology
  • Interventional Cardiology

Background:

  • Iatrogenic coronary artery dissection is a rare but serious complication of coronary angiography.
  • Dissections can lead to life-threatening conditions such as cardiogenic shock and cardiac arrest.

Observation:

  • A 54-year-old male patient developed spiral dissection of the right coronary artery during intervention for severe stenosis.
  • The patient experienced cardiac arrest and right ventricular failure, necessitating inotropic and mechanical circulatory support.

Findings:

  • A tortuous right coronary artery and use of a 6-F guiding catheter were identified as risk factors for dissection.
  • Despite a faulty Impella sensor, acute right ventricular failure was successfully managed with inotropic and mechanical circulatory support.

Implications:

  • Coronary artery dissection, though rare, is a treatable complication with stenting.
  • Cardiogenic shock following dissection can be effectively managed using inotropic and mechanical circulatory support strategies.
Abstract

Keywords:
dissectionleft-sided catheterizationright ventricle

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