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Int J Angiol 2024; 33(01): 062-065
DOI: 10.1055/s-0041-1735205
Case Report

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 
1   Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Indonesia/Harapan Kita National Cardiovascular Center, West Jakarta, Jakarta, Indonesia
,
Novi Kurnianingsih
2   Department of Cardiology and Vascular Medicine, Faculty of Medicine Brawijaya University/Dr. Saiful Anwar Hospital, Malang, East Java, Indonesia
,
Indra Prasetya
2   Department of Cardiology and Vascular Medicine, Faculty of Medicine Brawijaya University/Dr. Saiful Anwar Hospital, Malang, East Java, Indonesia
,
Faris W. Nugroho
2   Department of Cardiology and Vascular Medicine, Faculty of Medicine Brawijaya University/Dr. Saiful Anwar Hospital, Malang, East Java, Indonesia
,
Raman Uberoi
3   Department of Radiology, John Radcliffe Hospital, Headington, Oxford, United Kingdom
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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.

Keywords

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


Publication History

Article published online:
01 October 2021

© 2021. International College of Angiology. This article is published by Thieme.

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