Conservative management of ascending aortic dissection caused by percutaneous coronary intervention.

Despite notable refinements in percutaneous coronary intervention (PCI) techniques, these procedures are still associated with some morbidity and mortality. A case of elective coronary angioplasty is described that was complicated by coronary dissection and ST-elevation myocardial infarction. Subsequent efforts to recanalize the coronary artery resulted in a catheter-induced tear at the origin of the vessel, with proximal extension of the dissection to involve the ascending aorta. Literature relating to this complication (reviewed here) suggests that surgical management may be indicated under the circumstances we describe. However, a conservative approach was adopted in this instance with excellent long-term results.