Successful Primary PCI in Stanford Type A Aortic Dissection Complicated by Inferior ST-Elevation Myocardial Infarction: A Case in a Facility with No Surgical Backup

Suko Adiarto, Novi Kurnianingsih, Indra Prasetya, Faris W. Nugroho, Raman Uberoi

Research output: Contribution to journalArticlepeer-review

Abstract

Mortality of type A aortic dissection (TAAD) complicated with coronary malperfusion syndrome is very high even when emergency surgery is performed. Several reports suggested that primary percutaneous coronary intervention (PPCI) followed by immediate corrective surgery may reduce mortality. In many countries, immediate transfer to an aortic surgery center may not be possible. We report a case of TAAD complicated by coronary malperfusion successfully treated with PPCI followed by elective corrective surgery. A 48-year-old man was referred to emergency department with acute inferior ST-elevation myocardial infarction (STEMI) and underwent PPCI. During the procedure, we realized that the cause of STEMI was TAAD. We decided to continue because the patient experienced seizures and bradycardia. Subsequently, echocardiography and computed tomography confirmed the dissection. The patient was discharged and referred to the National Cardiovascular Center where he underwent successful elective surgery. In this patient, immediate revascularization was lifesaving and served as a bridging procedure before surgical correction.

Original languageEnglish
JournalInternational Journal of Angiology
DOIs
Publication statusAccepted/In press - 2021

Keywords

  • aortic dissection
  • coronary intervention
  • coronary malperfusion syndrome
  • malperfusion syndrome
  • primary PCI
  • STEMI
  • type A aortic dissection

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