Kalwar Muhammad Hashim, Sial Jawaid Akbar, Saghir Tahir, Rizvi Nadeem Hassan, Qamar Nadeem
National Institute of Cardiovascular Disease Karachi Pakistan.
J Pak Med Assoc. 2018 Apr;68(4):660-662.
Iatrogenic aortic dissection caused by primary percutaneous coronary intervention (PCI) is a rare but potentially fatal complication; therefore prompt recognition of this life-threatening condition is crucial. We present herein a case of a 70-year-old lady who underwent primary PCI for transmural myocardial infarction of left anterior descending artery territory. Manipulation of the extra backup (EBU) guiding catheter during an attempt to cannulate the left system resulted in an aortic dissection. The patient was managed conservatively with strict monitoring in the coronary care unit (CCU), and underwent serial evaluation with non-invasive imaging studies including a computed tomography angiography (CTA). On the 3rd post-procedure day, she developed cerebrovascular accident from which she recovered completely. Repeat CT angiogram showed complete resolution of the ascending aortic dissection. Initial follow-up was conducted at 2 weeks and the patient was doing well.
原发性经皮冠状动脉介入治疗（PCI）引起的医源性主动脉夹层是一种罕见但可能致命的并发症；因此，迅速识别这种危及生命的情况至关重要。我们在此介绍一例70岁女性患者，她因左前降支区域透壁心肌梗死接受了原发性PCI。在尝试插管左冠状动脉系统时，对额外备用（EBU）引导导管的操作导致了主动脉夹层。患者在冠心病监护病房（CCU）进行严格监测下保守治疗，并接受了包括计算机断层血管造影（CTA）在内的无创影像学研究的系列评估。术后第3天，她发生了脑血管意外，但已完全康复。重复CT血管造影显示升主动脉夹层完全消退。最初的随访在2周时进行，患者情况良好。
