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Non-surgical treatment of a coronarography-induced iatrogenic aortic dissection
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  • nicolas d'ostrevy,
  • lucie cassagnes,
  • nicolas Durel,
  • Lionel Camilleri
nicolas d'ostrevy
CHU Montpied
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lucie cassagnes
CHU Montpied
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nicolas Durel
Pôle Santé République
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Lionel Camilleri
Clermont-Ferrand university hospital,
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Abstract

Coronary dissection is an extremely rare but known complication of coronary catheterization and angioplasty. Due to its rarity, there are no management recommendations. However, surgery immediately after an endovascular procedure is frequently carried out under major antithrombotic treatment. The surgery and the postoperative consequences are therefore very complex. We report here the documented case of a type A aortic dissection after coronary catheterization. Despite extension to the entire ascending aorta which indicated surgical management, the benefit-risk balance argued for armed surveillance to avoid surgery under antiplatelets drugs without known antidote. We believe this case should lead us to systematically weigh the data before considering that any iatrogenic dissection of Dunning class 3 should be operated.