PMC10360360_01
(A) Electrocardiogram (ECG) showing ST-segment elevation (II/III/aVF) and inferior acute myocardial infarction. (B) Coronary angiography showing irregular long-segment stenosis of the right coronary artery from the opening to the middle segment. (C) After stent implantation, the right coronary artery shows good morphology and an unobstructed vascular lumen.
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F1
ECG showed ST-segment elevation (II/III/aVF) (Figure 1A), and myocardial enzyme levels were CK-MB 18.35 ng/ml and troponin 0.42 ng/ml. Coronary angiography showed severe stenosis of the starting part of the right coronary artery trunk (Figure 1B). Subsequently, PCI and coronary stent implantation were performed, as well as stenosis section recovery patency (Figure 1C).
Preoperative aortic CTA image. (A-D) CTA shows the false lumen of the ascending aorta compressing the true lumen, extending above the opening of the right coronary artery. They indicate a thick hematoma in the false lumen compressing the right coronary artery.
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F2
At this point, clinical physicians began to consider the possibility of AD, and an aortic CTA examination confirmed the diagnosis of type A AD (Figures 2A-D).
Postoperative aortic CTA image. (A) Artificial vessels in the aortic arch and the cephalobrachial artery are unobstructed. (B) Ascending aorta is unobstructed, and the stent is well dilated without internal leakage. (C) Opening of the right coronary artery is unobstructed, and stent implantation is visible. (D) Smooth morphology of the thoracic aorta.
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F3
POD20. Postoperative aortic CTA revealed that the artificial vessels were unobstructed (Figure 3A). The thoracic stent was well dilated without internal leakage (Figure 3B). The opening of the right coronary artery was unobstructed, the coronary stent implantation was visible (Figure 3C), and smooth morphology of the thoracic aorta was observed (Figures 3D, 4).
Timeline of the case.
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F4
The opening of the right coronary artery was unobstructed, the coronary stent implantation was visible (Figure 3C), and smooth morphology of the thoracic aorta was observed (Figures 3D, 4).