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      Dissection of Ascending Aorta: A Complication of Transradial Artery Access of Coronary Procedure

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          Abstract

          Iatrogenic acute dissection of ascending aorta following coronary angiography and percutaneous intervention is a rare complication. Most reports involve localized aortic dissections as a complication of cannulation of a coronary artery with propagation into the ascending aorta. It is usually treated by sealing the intima with a stent in the ostium of the coronary artery or conservative management, while extensive dissections may require a surgical intervention. We describe a case of the subclavian dissection extending into the ascending aorta that occurred during diagnostic catheterization using the radial approach. The patient was successfully treated utilizing conservative management.

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          Iatrogenic coronary artery dissections extending into and involving the aortic root.

          We set out to determine the incidence of iatrogenic coronary artery dissection extending into the aorta and to characterize the aortic lesions. We reviewed the data from 43,143 cardiac catheterizations from September 1993 through September 1999 and found 9 coronary artery-aortic dissections for an overall incidence of 0.02%. Four of these patients were undergoing treatment for acute myocardial infarction (AMI) and aortic dissection was more common than for non-AMI patients (0.19% vs. 0.01%, P 40 mm from the coronary os required surgical intervention.
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            Catheter-induced coronary artery dissection: risk factors, prevention and management.

            Guide catheter-induced dissection of the coronary arteries is an uncommon but potentially catastrophic complication of diagnostic and interventional cardiac catheterization. Several factors placing the individual at higher risk of this complication have been identified. We discuss these risk factors and utilize them to propose methods to prevent dissections. Management options of coronary artery dissection are also discussed.
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              Iatrogenic Acute Aortic Dissection during Percutaneous Coronary Intervention for Acute Myocardial Infarction.

              Iatrogenic acute aortic dissection during percutaneous coronary intervention is an extremely rare, but critical complication. Localized aortic dissections have been treated by sealing the entry with a coronary stent. Extensive dissections may require a surgical intervention. We present a case of type A extensive aortic dissection occurring during angioplasty of the left circumflex artery for acute myocardial infarction. This iatrogenic aortic dissection required emergent surgical repair with supracoronary replacement of the ascending aorta.
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                Author and article information

                Journal
                Heart Views
                Heart Views
                HV
                Heart Views : The Official Journal of the Gulf Heart Association
                Medknow Publications & Media Pvt Ltd (India )
                1995-705X
                0976-5123
                Apr-Jun 2018
                : 19
                : 2
                : 63-66
                Affiliations
                [1]Virginia Commonwealth University Hospital, Richmond, Virginia, USA
                Author notes
                Address for correspondence: Dr. Jose E. Exaire, Virginia Commonwealth University Hospital, Richmond, Virginia, USA. E-mail: jose.exaire@ 123456vcuhealth.org
                Article
                HV-19-63
                10.4103/HEARTVIEWS.HEARTVIEWS_102_17
                6219284
                cd310ae8-11b5-4c21-a20a-7148ede79b13
                Copyright: © 2018 Heart Views

                This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

                History
                Categories
                Case Report

                Cardiovascular Medicine
                complication of transradial access,dissection of ascending aorta,subclavian dissection

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