Percutaneous coronary intervention in critical occlusion of the left main coronary artery after acute aortic dissection.

We report the case of a 45-yr-old-male referred to our hospital with diagnosis of type A aortic dissection. During emergency surgery, the ascending aorta was replaced with a supracoronary tube, and a Y-shaped graft bypass was performed from aortic tube to brachiocephalic artery and left carotid artery due to the involvement of both carotids. Signs of myocardial ischemia appeared on the third week after surgery, with electrocardiographic changes, cardiac marker elevation and severe ventricular dysfunction. Coronary angiography showed critical stenosis of the left main coronary artery, due to extrinsic compression, and extensive dissection of the left coronary tree. The patient underwent percutaneous coronary intervention in which four intracoronary stents were placed with a satisfactory outcome.