Guide Catheter-Induced Aortic Dissection Complicated by Pericardial Effusion with Pulsus Paradoxus: A Case Report of Successful Medical Management

Aortic dissection is a rare but potentially fatal complication of percutaneous coronary intervention (PCI). Management strategies of PCI induced dissection are not clearly identified in literature; such occurrences often mandate surgical repair of the aortic root with reimplantation of the coronary...

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Main Authors: Magdalene Fiddler, Sriya A. Avadhani, Jonathan D. Marmur
Format: Article
Language:English
Published: Wiley 2015-01-01
Series:Case Reports in Medicine
Online Access:http://dx.doi.org/10.1155/2015/480242
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author Magdalene Fiddler
Sriya A. Avadhani
Jonathan D. Marmur
author_facet Magdalene Fiddler
Sriya A. Avadhani
Jonathan D. Marmur
author_sort Magdalene Fiddler
collection DOAJ
description Aortic dissection is a rare but potentially fatal complication of percutaneous coronary intervention (PCI). Management strategies of PCI induced dissection are not clearly identified in literature; such occurrences often mandate surgical repair of the aortic root with reimplantation of the coronary arteries. Another trend seen in case reports is the use of coronary-aortic stenting if such lesions permit. Several factors impact the management decision including the hemodynamic stability of the patient; mechanism of aortic injury; size, severity, and direction of propagation of the dissection; presence of an intimal flap; and preexisting atherosclerotic disease. We describe a case of a 65-year-old woman who underwent PCI for a chronic right coronary artery (RCA) occlusion, which was complicated by aortic dissection and pericardial effusion. Our case report suggests that nonsurgical management may also be appropriate for PCI induced dissections, and potentially even those associated with new pericardial effusion.
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spelling doaj-art-d68dc51b08304c10a1c846b9d5b00ece2025-08-20T03:23:42ZengWileyCase Reports in Medicine1687-96271687-96352015-01-01201510.1155/2015/480242480242Guide Catheter-Induced Aortic Dissection Complicated by Pericardial Effusion with Pulsus Paradoxus: A Case Report of Successful Medical ManagementMagdalene Fiddler0Sriya A. Avadhani1Jonathan D. Marmur2Department of Internal Medicine, SUNY Downstate Health Science Center, 450 Clarkson Avenue, Brooklyn, NY 11203, USADepartment of Internal Medicine, SUNY Downstate Health Science Center, 450 Clarkson Avenue, Brooklyn, NY 11203, USADepartment of Interventional Cardiology, SUNY Downstate Health Science Center, 450 Clarkson Avenue, Brooklyn, NY 11203, USAAortic dissection is a rare but potentially fatal complication of percutaneous coronary intervention (PCI). Management strategies of PCI induced dissection are not clearly identified in literature; such occurrences often mandate surgical repair of the aortic root with reimplantation of the coronary arteries. Another trend seen in case reports is the use of coronary-aortic stenting if such lesions permit. Several factors impact the management decision including the hemodynamic stability of the patient; mechanism of aortic injury; size, severity, and direction of propagation of the dissection; presence of an intimal flap; and preexisting atherosclerotic disease. We describe a case of a 65-year-old woman who underwent PCI for a chronic right coronary artery (RCA) occlusion, which was complicated by aortic dissection and pericardial effusion. Our case report suggests that nonsurgical management may also be appropriate for PCI induced dissections, and potentially even those associated with new pericardial effusion.http://dx.doi.org/10.1155/2015/480242
spellingShingle Magdalene Fiddler
Sriya A. Avadhani
Jonathan D. Marmur
Guide Catheter-Induced Aortic Dissection Complicated by Pericardial Effusion with Pulsus Paradoxus: A Case Report of Successful Medical Management
Case Reports in Medicine
title Guide Catheter-Induced Aortic Dissection Complicated by Pericardial Effusion with Pulsus Paradoxus: A Case Report of Successful Medical Management
title_full Guide Catheter-Induced Aortic Dissection Complicated by Pericardial Effusion with Pulsus Paradoxus: A Case Report of Successful Medical Management
title_fullStr Guide Catheter-Induced Aortic Dissection Complicated by Pericardial Effusion with Pulsus Paradoxus: A Case Report of Successful Medical Management
title_full_unstemmed Guide Catheter-Induced Aortic Dissection Complicated by Pericardial Effusion with Pulsus Paradoxus: A Case Report of Successful Medical Management
title_short Guide Catheter-Induced Aortic Dissection Complicated by Pericardial Effusion with Pulsus Paradoxus: A Case Report of Successful Medical Management
title_sort guide catheter induced aortic dissection complicated by pericardial effusion with pulsus paradoxus a case report of successful medical management
url http://dx.doi.org/10.1155/2015/480242
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