Iatrogenic Aortocoronary Dissection During Coronary Intervention: A Case Series.

Abstract

Iatrogenic aortocoronary dissection (IAD) during percutaneous coronary intervention (PCI) is an uncommon and potentially life-threatening complication. Extension of dissection to the ascending aorta, despite early surgical management, carries a high morbidity and mortality risk. Depending on the severity of dissection, the approach to management ranges from monitoring to surgical intervention; more extensive dissections into the ascending aorta, typically more than 40 mm above the coronary ostium, are considered an indication for surgery. We report six cases of IAD, highlighting the critical considerations concerning conservative management. These cases highlight the potential role of individualized management strategies, demonstrating instances where a conservative stance may prove effective in ensuring an optimal patient outcome and the key procedural features essential to optimize outcomes when considering nonsurgical management.