Iatrogenic Left Main Dissection Bailout Treatment with Stenting

Catheter-induced left main coronary artery (LMCA) dissection is a rare complication of coronary catheterization and is a common cause of periprocedural mortality. Although the number of cases was small, prompt bail-out stenting for iatrogenic LMCA dissection had reportedly reversed this complication with favorable clinical outcomes. A 60-year-old male was admitted to our hospital complaining of chest pain and breathlessness. Inspite on optimal and proper medical management patient has persistant chest pain. Coronary angiography was planned to rule out coronary artery disease. Left main got dissected while doing coronary angiography. Immediately, the patient complained of severe chest pain, accompanied by ST-segment elevation on the ECG and hemodynamic condition deteriorated. Emergent bail out stenting was done with drug eluting stent of size 4.5X14mm placed in left main (LM) overlapping with 3.5X20mm in LAD, re-establishing TIMI 3 flow in LAD. The patient was stable without symptoms after the procedure. He was discharged five days later on optimal medical treatment