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Case Reports
. 2021 Sep 22:8:731581.
doi: 10.3389/fcvm.2021.731581. eCollection 2021.

Case Report: Intraoperative Open-Heart Coronary Angiography in Acute Type A Aortic Dissection

Jue Yang  1 , Xin Li  1 , Zerui Chen  1 , Tucheng Sun  1 , Ruixin Fan  1 , Changjiang Yu  1
Affiliations
Case Reports

Case Report: Intraoperative Open-Heart Coronary Angiography in Acute Type A Aortic Dissection

Jue Yang et al. Front Cardiovasc Med. .

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.

Keywords: aortic dissection; case report; coronary angiography; coronary artery disease; open-heart.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
(A) MDCT image of the LAD in an enhancement scan. (B) MDCT image of the LAD in a plain scan. LAD, left anterior descending coronary artery; MDCT, multidetector computed tomography.
Figure 2
Figure 2
Visualization of the coronary angiography. (A) Intraoperative open-heart coronary angiography shows no significant stenosis in the left coronary artery. (B) Intraoperative open-heart coronary angiography shows no significant stenosis in the right coronary artery. LAD, left anterior descending coronary artery; LCX, left circumflex coronary artery.
See this image and copyright information in PMC

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