Iatrogenic Catheter-Induced Acute Aortic Dissection Type A after Coronary Angiography—A Retrospective Consecutive Case Series
Autor: | Miriam Freundt, Azizolah Rahimi-Barfeh, Jochen Cremer, Jochen Renner, F. Schoeneich, Philipp J. Schäfer, Jan Dreyer, Assad Haneya, Christina Grothusen, Katharina Huenges, Bernd Panholzer, J Schöttler |
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Rok vydání: | 2016 |
Předmět: |
Male
Pulmonary and Respiratory Medicine Coronary angiography Cardiac Catheterization medicine.medical_specialty Time Factors Myocardial ischemia Iatrogenic Disease 030204 cardiovascular system & hematology Coronary Angiography Cardiac Catheters Blood Vessel Prosthesis Implantation 03 medical and health sciences Postoperative Complications 0302 clinical medicine Risk Factors Germany medicine.artery Internal medicine Ascending aorta medicine Humans Aorta Severe complication Aged Retrospective Studies Aged 80 and over Aortic dissection business.industry fungi Hemodynamics Consecutive case series Middle Aged Vascular System Injuries medicine.disease Aortic Aneurysm Surgery Aortic Dissection Catheter Treatment Outcome medicine.anatomical_structure 030228 respiratory system Acute Disease Cardiology Female Cardiology and Cardiovascular Medicine business Artery |
Zdroj: | The Thoracic and Cardiovascular Surgeon. 65:085-089 |
ISSN: | 1439-1902 0171-6425 |
Popis: | Background Acute aortic dissection type A (AADA) is one of the most life-threatening situations and surgical demanding procedures even today. Usually AADA develops spontaneously, but it can be related also to interventional procedures. Methods We analyzed the data of 14 patients surgically treated in our institution with catheter-induced AADA (ciAADA) during coronary angiography between January 2004 and December 2014. Data were compared with overall AADA patients in this time period (n = 288). Results Nine of the 14 patients were female. Subjects were significantly older compared to the AADA patients (69 ± 11 vs. 62 ± 11; p = 0.021). At admission, ciAADA patients were more often hemodynamically instable and mechanically ventilated. Twelve patients underwent replacement of the ascending aorta and two patients received a modified Bentall operation. Cardiopulmonary bypass time (210 ± 92 vs. 172 ± 51 min) and cross-clamp time (122 ± 63 vs. 92 ± 40 min) were significantly longer due to additional coronary artery bypass grafts in 71.4 versus 3.1% due to myocardial ischemia. Operative mortality (7.1 vs. 2.1%, p = 0.29) and 30-day mortality (50.0 vs. 10.7%, p Conclusion Coronary angiography–induced AADA is a rare but severe complication. Due to additional myocardial ischemia and preoperative hemodynamic instability, patients with ciAADA have adverse outcome compared to overall AADA patients. |
Databáze: | OpenAIRE |
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