Conflict of interest: Nothing to report.
Coronary Artery Disease
Left main dissection conservatively managed with optical coherence tomography guidance
Article first published online: 3 JUL 2013
Copyright © 2013 Wiley Periodicals, Inc.
Catheterization and Cardiovascular Interventions
Volume 83, Issue 1, pages 65–68, 1 January 2014
How to Cite
Binder, R. K., Boone, R. H. and Webb, J. G. (2014), Left main dissection conservatively managed with optical coherence tomography guidance. Cathet. Cardiovasc. Intervent., 83: 65–68. doi: 10.1002/ccd.24978
- Issue published online: 18 DEC 2013
- Article first published online: 3 JUL 2013
- Accepted manuscript online: 24 APR 2013 03:31AM EST
- Manuscript Accepted: 14 APR 2013
- Manuscript Received: 20 JAN 2013
- left main dissection;
- percutaneous coronary intervention;
- optical coherence tomography;
Left main dissection (LMD) is a rare but feared complication of cardiac catheterization. It is usually managed by bailout stent implantation or coronary artery bypass surgery. We describe a case of iatrogenic, retrograde LMD during percutaneous coronary intervention. After covering the retrograde entry of the dissection in the ostial left anterior descending artery (LAD), optical coherence tomography (OCT) showed, that there was no antegrade entry in the left main and that the minimal true lumen area in the left main was 7.2 mm2. It was therefore decided to treat the LMD conservatively and reassess the results by angiography 6 months later. At follow-up angiography, no stenosis or residual dissection in the left main were noted. The patient was doing fine at 1-year follow-up. OCT is a valuable tool for assessing coronary artery dissections and may guide the decision, whether to stent or not to stent a dissection. In selected cases LMD may be managed conservatively. © 2013 Wiley Periodicals, Inc.