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Yang J, Li X, Chen Z, Sun T, Fan R, Yu C. Case Report: Intraoperative Open-Heart Coronary Angiography in Acute Type A Aortic Dissection. Front Cardiovasc Med 2021; 8:731581. [PMID: 34631830 PMCID: PMC8492995 DOI: 10.3389/fcvm.2021.731581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Accepted: 08/25/2021] [Indexed: 11/17/2022] Open
Abstract
For patients with acute type A aortic dissection, strongly suspected of having concomitant severe coronary artery disease (CAD), preoperative or intraoperative coronary angiography has been recommended. However, conventional selective coronary angiography in this setting may extend the dissection or aortic rupture. We present the use of intraoperative open-heart coronary angiography in a patient with acute type A aortic dissection. A 50-year-old man presented with chest pain and dyspnea and was admitted to our department with acute type A aortic dissection. The patient underwent coronary artery stent implantation in the left anterior descending coronary artery (LAD) 3 years previously due to an acute myocardial infarction. This time we failed to evaluate the patency of the LAD using multidetector computed tomography. An aortic rupture occurred due to conventional coronary angiography, and open-heart coronary angiography was performed. The examination revealed no significant stenosis. A Bentall procedure and total aortic arch replacement were performed, with an intraoperative stent inserted into the descending aorta, and the patient had an uneventful postoperative course. From this case, we learn that intraoperative open-heart coronary angiography is safe and effective in patients with acute type A aortic dissection.
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Affiliation(s)
- Jue Yang
- Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Department of Cardiac Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Xin Li
- Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Department of Cardiac Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Zerui Chen
- Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Department of Cardiac Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Tucheng Sun
- Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Department of Cardiac Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Ruixin Fan
- Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Department of Cardiac Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Changjiang Yu
- Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Department of Cardiac Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
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van der Linden M, Heuts S, Veenstra L, Lorusso R. Intraoperative, open-heart coronary angiography in severe acute aortic valve endocarditis. Eur J Cardiothorac Surg 2019; 56:415-417. [PMID: 30596996 DOI: 10.1093/ejcts/ezy434] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 11/12/2018] [Accepted: 11/17/2018] [Indexed: 12/31/2022] Open
Abstract
We present the use of intraoperative open-heart coronary angiography in a patient with aortic valve endocarditis and extensive coronary calcification on coronary computed tomography angiography. Open-heart angiography was performed intraoperatively and revealed no significant stenoses. Aortic valve replacement without concomitant bypass surgery was performed, and the patient had an uneventful postoperative course.
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Affiliation(s)
- Marcel van der Linden
- Department of Cardiothoracic Surgery, Maastricht University Medical Center+, Maastricht, Netherlands
| | - Samuel Heuts
- Department of Cardiothoracic Surgery, Maastricht University Medical Center+, Maastricht, Netherlands
| | - Leo Veenstra
- Department of Cardiology, Maastricht University Medical Center+, Maastricht, Netherlands
| | - Roberto Lorusso
- Department of Cardiothoracic Surgery, Maastricht University Medical Center+, Maastricht, Netherlands
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Kilian E, Beiras-Fernandez A, Bauerfeind D, Reichart B, Lamm P. Intraoperative coronary angiography in the management of patients with acute aortic dissection and endocarditis. J Thorac Cardiovasc Surg 2008; 136:792-3. [DOI: 10.1016/j.jtcvs.2008.01.025] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2007] [Revised: 12/28/2007] [Accepted: 01/13/2008] [Indexed: 11/26/2022]
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