CC BY-NC-ND 4.0 · Thorac Cardiovasc Surg Rep 2020; 09(01): e47-e50
DOI: 10.1055/s-0040-1715431
Case Report: Vascular

Conservative Treatment of Iatrogenic Ascending Aortic Hematoma Post-Rotablator Coronary Procedure

Maxime Doutriaux
1   Department of Cardiology, CHI Poissy-Saint-Germain-en-Laye Site Hospitalier de Poissy, Poissy, France
,
Benjamin Pariente
1   Department of Cardiology, CHI Poissy-Saint-Germain-en-Laye Site Hospitalier de Poissy, Poissy, France
,
Jad Zahnan
1   Department of Cardiology, CHI Poissy-Saint-Germain-en-Laye Site Hospitalier de Poissy, Poissy, France
,
Xavier Marchand
1   Department of Cardiology, CHI Poissy-Saint-Germain-en-Laye Site Hospitalier de Poissy, Poissy, France
› Author Affiliations

Abstract

Background Aortic intramural hematoma due to coronary artery dissection is a rare and serious complication during percutaneous coronary intervention.

Case Presentation A 78-year-old female patient was admitted for diagnostic coronarography in the context of stable angina. The coronarography showed an asymmetric and significate calcification in the ostium of the right coronary requiring Rotablator (Boston Scientific) procedure complicated by iatrogenic ascending aortic hematoma. After surgical advice, a conservative approach was decided with total hematoma resorption and recovery 1 week later.

Conclusion With stable patient, conservative treatment may be suitable after aortic hematoma due to coronary dissection.



Publication History

Received: 29 April 2020

Accepted: 26 May 2020

Article published online:
12 October 2020

© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Georg Thieme Verlag KG
Stuttgart · New York

 
  • References

  • 1 Núñez-Gil IJ, Bautista D, Cerrato E. , et al; Registry on Aortic Iatrogenic Dissection (RAID) Investigators. Incidence, management, and immediate- and long-term outcomes after iatrogenic aortic dissection during diagnostic or interventional coronary procedures. Circulation 2015; 131 (24) 2114-2119
  • 2 Welch TD, Foley T, Barsness GW. et al. Iatrogenic aortic dissection ... or intramural hematoma?. Circulation 2012; 125 (09) e415-e418
  • 3 Muhyieddeen K, Samim A, Roberts M, Srikanth S. A case of iatrogenic aortic intramural hematoma. Methodist Debakey Cardiovasc J 2017; 13 (01) 37-38
  • 4 de Barros e Silva PG, Aquino T, Resende MV. et al. Resolution of an acute aortic syndrome with aortic valve insufficiency post-PCI. Am J Case Rep 2014; 15: 508-513
  • 5 Shorrock D, Michael TT, Patel V. et al. Frequency and outcomes of aortocoronary dissection during percutaneous coronary intervention of chronic total occlusions: a case series and systematic review of the literature. Catheter Cardiovasc Interv 2014; 84 (04) 670-675
  • 6 Valgimigli M, Bueno H, Byrne RA. , et al; ESC Scientific Document Group; ESC Committee for Practice Guidelines (CPG); ESC National Cardiac Societies. 2017 ESC focused update on dual antiplatelet therapy in coronary artery disease developed in collaboration with EACTS: the Task Force for dual antiplatelet therapy in coronary artery disease of the European Society of Cardiology (ESC) and of the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J 2018; 39 (03) 213-260
  • 7 Harris KM, Braverman AC, Eagle KA. et al. Abstract 17170: Acute aortic intramural hematoma: an analysis from the International Registry of Acute Aortic Dissection. Circulation 2012; 126 (11) (Suppl. 01) S91-S96
  • 8 Roumy A, Kirsch M, Prêtre R, Niclauss L. Spontaneous regression of a large iatrogenic dissection of the ascending aorta. Aorta (Stamford) 2016; 4 (06) 226-228
  • 9 Rylski B, Hoffmann I, Beyersdorf F. et al. Iatrogenic acute aortic dissection type A: insight from the German Registry for Acute Aortic Dissection Type A (GERAADA). Eur J Cardiothorac Surg 2013; 44 (02) 353-359 , discussion 359
  • 10 Iannopollo G, Gallo F, Mangieri A. et al. Tips and tricks for rotational atherectomy. J Invasive Cardiol 2019; 31 (12) E376-E383