{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T14:35:19Z","timestamp":1773758119856,"version":"3.50.1"},"reference-count":12,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2022,1,21]]},"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:p>Stanford type A acute aortic syndromes (AAS) can be complicated with acute coronary closure and ST segment elevation myocardial infarction (STEMI) leading to significant additional morbidity and mortality. The recommended treatment for type A AAS is emergency cardiac surgery. We present the case of a patient with intramural haematoma involving the ascending and descending aorta complicated with anterior wall STEMI after CT imaging. Coronary angiography and intravascular ultrasonography (IVUS) revealed the dissection spiralling into the media of the left main stem (LMS) and left anterior descending (LAD) coronary artery. In the setting of acute vessel closure and ongoing myocardial ischaemia primary percutaneous coronary intervention (PCI) was performed to the LMS, LAD and second diagonal branch prior to successful emergency cardiac surgery with an aortic-arch interposition graft. Emergency IVUS-guided stenting to relieve acute coronary occlusion in the context of aortic dissection can be performed in selected cases to safely bridge the patient for cardiac surgery.<\/jats:p>","DOI":"10.1136\/bcr-2021-248055","type":"journal-article","created":{"date-parts":[[2022,3,8]],"date-time":"2022-03-08T11:45:32Z","timestamp":1646739932000},"page":"e248055","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Anterior STEMI complicating acute aortic syndrome: mechanistic insight and bridge to surgery with intravascular ultrasound-guided primary PCI"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9037-0907","authenticated-orcid":false,"given":"Gautam","family":"Sen","sequence":"first","affiliation":[{"name":"Department of Cardiology, Salisbury NHS Foundation Trust, Salisbury, Wiltshire, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alice","family":"Veitch","sequence":"additional","affiliation":[{"name":"Department of Radiology, Salisbury NHS Foundation Trust, Salisbury, Wiltshire, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sergio","family":"Nabais","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Salisbury NHS Foundation Trust, Salisbury, Wiltshire, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,3,8]]},"reference":[{"key":"2025082707271196000_15.3.e248055.1","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1093\/eurheartj\/ehx393","article-title":"2017 ESC guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: the task force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of cardiology 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