Iatrogenic aortic dissection during percutaneous coronary intervention: A case report and review of the literature

A 64-year-old female complaining of unrelieved chest pain for 2 days was admitted to the Emergency Room of the Beijing Anzhen Hospital, Beijing, China. After definitive diagnosis, a percutaneous coronary intervention was implemented, but immediately after embedding the stent in the distal area of the right coronary artery, an acute coronary and aortic dissection was found. Cardiologists immediately gave the patient conservative management. At the same time, another smaller stent was immediately embedded in the proximal area of the right coronary artery and plunged into the ascending aorta by 2mm, with the intention of covering the tear of the dissection. Repeated coronary angiography showed that a 40% stricture of the distal right coronary artery remained and less contrast agent had been extravasated. The patient was then transferred to the Department of Cardiac Surgery and received emergency surgery consisting of right coronary artery bypass grafting and ascending aorta replacement. The patient remained in the intensive care unit for 18 days after the surgery. The patient recovery was acceptable and she was discharged with a small amount of bilateral hydrothorax, moderate malnutrition oedema and iron deficiency anaemia.