Açık kalp cerrahi desteği olmayan bir merkezde iatrojenik sol ana koroner arter diseksiyon yönetimi

Abstract

Katatere bağlı iatrojenik sol ana koroner arter diseksiyonu son derece nadir görülen ancak erken farkedilip tedavi planlaması yapılmadığında ölümcül sonuçlara sebep olabilen bir komplikasyondur. Güncel yaklaşımda konservatif izlem, perkutan girişimle bailout stentleme, bypass cerrahisi tedavi seçenekleri mevcuttur. Ancak bazı merkezlerde cerrahi destek olmadan koroner anjiografi ve girişimsel uygulamalar yapılmaktadır. Bu gibi nadir ama önemli komplikasyonların yönetimi bu merkezlerde daha karmaşık hale gelmektedir. Bu konuda yaşadığımız bu tecrübede stent implante edebilmek için kateteri derin entübasyon yapmak durumunda kaldığımız 72 yaş bayan hastada katetere bağlı gelişen iatrojenik sol ana koroner arter diseksiyonunu cerrahi destek olmayan merkezde bailout stentleme ve konservatif yaklaşımla nasıl yönettiğimizi kendisinin onayı alındıktan sonra paylaşmak istedik.

Keywords

• Koroner arter diseksiyonu
• Stent
• Anjiografi

Management of iatrogenic left main coronary artery dissection in a center without onsite cardiac surgery back up

Abstract

Catheter-related iatrogenic left main coronary artery dissection is an extremely rare complication that can cause fatal outcomes if not recognized and treated early. In the current approach, conservative follow-up, bailout stenting with percutaneous intervention and bypass surgery treatment options are available. However, in some centers, coronary angiography and interventional applications are performed without surgical support. Management of such rare but important complications becomes more complex in these centers. In this experience, we wanted to share after her approval, how we managed catheter-induced iatrogenic left main coronary artery dissection in a 72-year-old female patient with bailout stenting and conservative approach in a center without surgical back up.

Keywords

• Coronary artery dissection
• Stent
• Angiography

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