Late presentation of iatrogenic dissection of right coronary cusp: A case report.

Ali Eshraghi,Javad Ramezani,Mostafa Baburian,Majid Jalalyazdi

doi:10.34172/jcvtr.2020.55

Ali Eshraghi, Javad Ramezani + Show 2 more

Open Access

https://doi.org/10.34172/jcvtr.2020.55

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Abstract

Iatrogenic dissection of coronary arteries while performing catheter engagement, in general is not uncommon. However, we encountered a relatively rare case of iatrogenic right coronary cusp dissection.Here we report an iatrogenic coronary artery dissection after diagnostic angiography in a 54-year-oldwoman presented with exertional dyspnea and chest discomfort. In our case delayed progression of sub-intimal hematoma and subsequent compression of RCA ostium an SA node branch was the cause of SA node dysfunction and subsequent junctional rhythm and atrial fibrillation. To conclude it should be said that in catastrophic cases of iatrogenic coronary ostia dissection and ensuing aortic cusp involvement, stenting of entry point at coronary ostia is a logical decision with good result.

Highlights

In recent years, trans-radial artery approach has become popular among cardiologists for both diagnostic coronary angiography and percutaneous coronary intervention (PCI)
It should be mentioned that the rate of iatrogenic coronary artery dissection after PCI is almost twenty times higher compared to its incidence after coronary angiography.[3]
In this report we present a case of catheter-induced right coronary sinus and ascending aortic dissection following diagnostic angiography

Summary

Introduction

Trans-radial artery approach has become popular among cardiologists for both diagnostic coronary angiography and percutaneous coronary intervention (PCI). Iatrogenic coronary artery dissection following the angiography of coronary arteries is a rare condition with high mortality rate if not diagnosed and treated early.[2] It is reported that its incidence is as low as 0.02%. It should be mentioned that the rate of iatrogenic coronary artery dissection after PCI is almost twenty times higher compared to its incidence after coronary angiography.[3]

Results

Conclusion