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
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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