Staged Hybrid Rescue With Preoperative PCI via Ascending Aortic Stent in Type A Aortic Dissection.

BACKGROUND

Acute type A aortic dissection (ATAAD) with a completely thrombosed false lumen that causes true lumen collapse and coronary malperfusion is a rare but life-threatening condition.

CASE SUMMARY: A 58-year-old man presented with epigastric and back pain. Subsequently, the patient developed shock. An ATAAD with a completely thrombosed false lumen and true lumen collapse was identified in the ascending aorta, resulting in severe ostial stenosis of the left main coronary artery. A bare-metal stent was deployed in the ascending aorta to restore the true lumen patency. Percutaneous coronary intervention (PCI) using stent struts improved coronary perfusion and hemodynamics. The patient subsequently underwent definitive-stage surgical repair.

DISCUSSION: In selected ATAAD cases, ascending aortic stenting enables bridging PCI and hemodynamic stabilization before surgical repair.

TAKE-HOME MESSAGE: Ascending aortic stenting may facilitate preoperative bridging PCI for hemodynamic stabilization in selected patients with ATAAD.