ISSN 1016-5169 | E-ISSN 1308-4488
Archives of the Turkish Society of Cardiology
Iatrogenic type A aortic dissection during percutaneous coronary intervention: A single-center experience [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2021; 49(2): 108-119 | DOI: 10.5543/tkda.2021.99978

Iatrogenic type A aortic dissection during percutaneous coronary intervention: A single-center experience

Veysel Özgür Barış1, Serkan Asil2, Murat Çelik2, Suat Görmel2, Uygar Çağdaş Yüksel2
1Department of Cardiology, Dr. Ersin Arslan Training and Research Hospital, Gaziantep, Turkey
2Department of Cardiology, Gülhane Training and Research Hospital, Ankara, Turkey


OBJECTIVE
Iatrogenic aortic dissection (IAD) during coronary interventions is a rare but fatal complication. There is not enough experience and trial on this subject. In this study, we report our IAD cases and their acute, short-term, and long-term results.

METHODS
In this study, we screened 6,096 coronary angiographies performed in our center between February 2016 and February 2019. Ascending aortic dissection developed in 8 patients. A total of 7 patients had computed tomographic angiography images after the event and during the follow-up. We performed 1-month and 1-year follow-up examinations.

RESULTS
The incidence of IAD was 0.13%. The female sex ratio was as 63%. A total of 37% of the patients had presented with acute coronary syndrome. In 37% of the patients, dissection occured while support catheter use, but in the remaining patients, dissections developed owing to hydraulic pressure. Regardless of the Dunning staging, 7 patients were followed-up with medical treatment, and 1 patient with decreased coronary flow was referred to emergency coronary bypass surgery. Regression was in the first tomography in 4 patients and observed in the control tomography in the remaining patients with medical treatment. The in-hospital 1-month and 1-year mortality rates were 0%.

CONCLUSION
IAD is a fatal disease, and conservative follow-up is suggested due to lack of clear management recommendations. The findings in our study showed that medical treatment is the first choice for the hemodynamically stable patients when dissection is sealed by stenting; however, surgical treatment is required in patients with the decreased coronary flow.

Keywords: Aortic dissection, Complication, Percutaneous coronary intervention

How to cite this article
Veysel Özgür Barış, Serkan Asil, Murat Çelik, Suat Görmel, Uygar Çağdaş Yüksel. Iatrogenic type A aortic dissection during percutaneous coronary intervention: A single-center experience. Turk Kardiyol Dern Ars. 2021; 49(2): 108-119

Corresponding Author: Veysel Özgür Barış, Türkiye
Manuscript Language: English


Journal Metrics

Journal Citation Indicator: 0.18
CiteScore: 1.1
Source Normalized Impact
per Paper:
0.22
SCImago Journal Rank: 0.348

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