Dissection of ascending aorta and left main coronary artery after routine percutaneous coronary intervention: a case report

We describe a case of guiding catheter induced dissection of left main coronary artery and ascending aorta. A patient with unstable angina and two-vessel disease underwent drug eluting stents implantation in proximal left anterior descending artery and distal left circumflex artery. Six hours after the procedure of acute occlusive dissection of left main coronary artery with spreading to ascending aorta developed, it was required to do stenting of the left anterior descending and left main coronary arteries and balloon dilatation of left circumflex artery. Despite the initial success of the repeated intervention, total occlusion of left main coronary artery occurred with unsuccessful reopening in catheterization laboratory. Emergency coronary artery bypass surgery was carried out. However, despite the patent anastomosis from left mammary to left anterior descending artery, the patient died.