Percutaneous Management of Iatrogenic Aortocoronary Dissection Complicating Diagnostic Angiography or Percutaneous Coronary Intervention

Introduction

Aortocoronary dissection is an infrequent, yet potentially catastrophic complication of coronary angiography (CAG) or percutaneous coronary intervention (PCI) that can lead to emergency surgical aortic repair, coronary artery bypass graft surgery (CABG) or death.^, According to the extent of aortic root involvement, Dunning et al. proposed three classes of aortocoronary dissection: Class I for focal dissection limited to the sinus of Valsalva; Class II for dissection that propagated less than 40 mm to the ascending aorta; and Class III for dissection extending 40 mm or more to the ascending aorta. Management of this rare entity is still technically challenging and the optimal treatment of aortocoronary dissection complicating CAG or PCI had not been clearly established. In this article, we describe a case series of aortocoronary dissection among consecutive diagnostic CAG and PCI procedures, which were successfully treated by coronary ostial stenting.

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