An Unexpected Cause of Acute Coronary Syndrome: Iatrogenic Right Coronary Dissection as a Delayed Complication after Valve Replacement Surgery

Ana Redondo Palacios, José López Menéndez, Laura Varela Barca, Miren Martín García



Coronary artery dissection is an unfrequent complication, which in an important number of cases has a iatrogenic cause. Most of them occur after a percutaneous procedure, and usually the right coronary artery is the one affected.

We report the case of a iatrogenic right coronary dissection after valve replacement surgery. The cause was assumed to be the antegrade cannulation of the ostium for cardioplegic perfussion.

What we consider particularly interesting about this case is that it had a delayed clinical manifestation, 9 days after surgery, having a normal immediate post-operative course. The diagnosis was achieved by coronary angiography, and no interventional treatment was performed.


coronary dissection, iatrogenic, ostium, cardioplegia


E. La Franca, D. Piraino, B. Cortese, M. Carella, D. Buccheri, G. Dendramis, et al., Immediate decision making in a case of iatrogenic dissection of left main coronary artery: A successful synergetic treatment, Int. J. Cardiol. 202 (2016) 77–79. doi:10.1016/j.ijcard.2015.08.140.

J.H. Rogers, J.M. Lasala, Coronary artery dissection and perforation complicating percutaneous coronary intervention., J. Invasive Cardiol. 16 (2004) 493–9.

P. Eshtehardi, P. Adorjan, M. Togni, H. Tevaearai, R. Vogel, C. Seiler, et al., Iatrogenic left main coronary artery dissection: Incidence, classification, management, and long-term follow-up, Am. Heart J. 159 (2010) 1147–1153. doi:10.1016/j.ahj.2010.03.012.

M. Kyavar, H. Bassiri, A. Sadeghpour, A. Alizadehasl, H. Pouraliakbar, F. Kargar, Left main coronary artery dissection after valve replacement: role of coronary computed tomographic angiography., Tex. Heart Inst. J. 39 (2012) 770–1. PMid: 23109793 PMCid: PMC3461684

F. de P. Machado, R.O. Sampaio, F.L. Mazzucato, F. Tarasoutchi, G.S. Spina, M. Grinberg, [Acute coronary artery dissection after aortic valve replacement]., Arq. Bras. Cardiol. 94 (2010) e23–5, e82–5, e31–4.

A. Funada, S. Mizuno, K. Ohsato, T. Murakami, I. Moriuchi, K. Misawa, et al., Three cases of iatrogenic coronary ostial stenosis after aortic valve replacement., Circ. J. 70 (2006) 1312–7. hhtp://

Shewan LG, Coats AJS, Henein M. Requirements for ethical publishing in biomedical journals. International Cardiovascular Forum Journal 2015;2:2 DOI: 10.17987/icfj.v2i1.4


Copyright (c) 2016 Ana Redondo Palacios

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.