Korean Circ J.  2019 Apr;49(4):363-365. 10.4070/kcj.2018.0284.

Computerized Tomography is an Effective Modality to Evaluate Iatrogenic Aortocoronary Dissection with Acute Myocardial Infarction

• Lee SI
• Park CH
• Kang WC
• Oh PC

• KMID: 2441141
• DOI: http://doi.org/10.4070/kcj.2018.0284

Abstract

No abstract available.

MeSH Terms

Myocardial Infarction*

Figure

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  Figure 1 (A, B) Baseline coronary angiogram showed significant stenosis at the proximal left anterior descending artery and the mid RCA. (C) Coronary angiogram showed spiral dissection (arrow) of the RCA from ostium to mid portion with total occlusion. The dissection was extended to the right coronary sinus of the aortic root. RCA = right coronary artery.

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  Figure 2 Cardiac computerized tomogram. A flap formed by the right coronary artery dissection was identified at the ostium (arrow). Extended dissection flap of aortic root was localized at sinus of Valsalva without propagation into ascending aorta.

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  Figure 3 (A) Follow-up coronary angiogram on the seventh hospital day showed no interval change of the spiral dissection of RCA. However, localized dissection of sinus of Valsalva was decreased. (B) Percutaneous coronary intervention was performed at the proximal left anterior descending artery with a drug-eluting stent (arrow) and left coronary angiogram showed collateral flow (Rentrop grade 2) from the left coronary artery to the distal RCA (dotted arrow). RCA = right coronary artery.

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  Figure 4 (A) After 3 months, follow-up angiography showed no significant change of the spiral dissection of RCA with slit-like true lumen (arrow). (B) Percutaneous coronary intervention was strugglingly performed from the distal portion (dotted arrow) to the ostium (arrow) of RCA with 4 drug-eluting stents. (C) Completion angiogram showed no visible dissecting flap and no residual stenosis at RCA with thrombolysis in myocardial infarction flow grade 3. RCA = right coronary artery.

Reference

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