Editorial Comment: ECG-Gated Aortic CTA for Characterization of Coronary Artery Involvement in Proximal Aortic Dissection Assists in Surgical Planning

2021 ◽  
Author(s):  
Marianna Zagurovskaya
Keyword(s):  
Coronary Artery ◽  
Aortic Dissection ◽  
Editorial Comment ◽  
Surgical Planning ◽  
Coronary Artery Involvement

scholarly journals Tumor Encasement of the Right Coronary Artery: Role of Anatomic and Functional Imaging in Diagnosis and Therapeutic Management

2014 ◽  
Vol 8 (1) ◽  
pp. 110-112 ◽  
Author(s):  
Yu-Hsiang Juan ◽  
Yiannis S Chatzizisis ◽  
Sachin S Saboo ◽  
Tatiana Rocha ◽  
Michael L Steigner
Keyword(s):  
Coronary Artery ◽  
Right Coronary Artery ◽  
Surgical Planning ◽  
Mediastinal Tumor ◽  
Treatment Approach ◽  
Mediastinal Tumors ◽  
Coronary Artery Involvement ◽  
Poorly Differentiated ◽  
The Right

We presented two rare cases of mediastinal tumor encasing the right coronary artery (RCA), one with recurrent metastatic thymoma and another with primary poorly differentiated neoplasm. Different degrees and locations of RCA involvement were noted. The treatment approach varied from conservative to surgical. Coronary artery involvement by mediastinal tumors is important to be investigated with imaging as it may guide the surgical planning.

Preoperative imaging risk findings for postoperative new stroke in patients with acute type A aortic dissection

2020 ◽  
Author(s):  
Hongliang Zhao ◽  
Fan Guo ◽  
Jingji Xu ◽  
Yuanqiang Zhu ◽  
Didi Wen ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Aortic Dissection ◽  
Cerebral Infarction ◽  
Aortic Arch ◽  
False Lumen ◽  
Preoperative Imaging ◽  
Acute Type ◽  
Type A Aortic Dissection ◽  
Coronary Artery Involvement ◽  
Postoperative Stroke

Abstract Background Stroke is a common postoperative complication in patients with acute type A aortic dissection (ATAAD). We aimed to explore the preoperative imaging risk findings for postoperative new stroke in patients with ATAAD. Methods From January 2015 to December 2018, 174 patients with ATAAD who underwent preoperative aortic computed tomography angiography (CTA) and cerebral diffusion-weighted imaging (DWI) as well as postoperative brain CT were included, and divided into DWI (+) and DWI (-) groups. Pre- and intraoperative variables were collected, and logistic regression analysis was used to determine the independent risk predictors of postoperative new stroke. Results The incidence of postoperative new stroke was 18.4% (32/174) in patients with ATAAD. Postoperative stroke was detected in 13 (31.0%) patients in the DWI (+) group and in 19 (14.4%) patients in the DWI (-) group with significant difference (P = 0.016). In the DWI (+) group, the lesions of the cerebral infarction located in the unilateral cerebral hemisphere and distributed more than three lobes (P = 0.007) were an independent risk factor for postoperative new stroke. Hypotension (P = 0.002), retrograde ascending aorta dissection with thrombosis of the false lumen (P = 0.010), aortic arch entry (P = 0.035), and coronary artery involvement (P = 0.001) were independent risk factors for postoperative stroke in the DWI (-) cohort. Conclusions Patients with ATAAD with cerebral infarction are more likely to develop postoperative new stroke; thus, a preoperative DWI examination may be necessary. DWI lesions distributed more than 3 lobes in the unilateral hemisphere suggest a high possibility of postoperative stroke. For patients with ATAAD with normal brain, particular attention should be given to the CTA findings of false lumen thrombosis, aortic arch entry, and coronary artery involvement to avoid postoperative stroke. Trial registration: Retrospectively registered.

scholarly journals Preoperative Imaging Risk Findings for Postoperative New Stroke in Patients With Acute Type A Aortic Dissection

2020 ◽  
Vol 7 ◽  
Author(s):  
Hongliang Zhao ◽  
Fan Guo ◽  
Jingji Xu ◽  
Yuanqiang Zhu ◽  
Didi Wen ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Aortic Dissection ◽  
Cerebral Infarction ◽  
Aortic Arch ◽  
False Lumen ◽  
Preoperative Imaging ◽  
Acute Type ◽  
Type A Aortic Dissection ◽  
Coronary Artery Involvement ◽  
Postoperative Stroke

Background: Stroke is a common postoperative complication in patients with acute type A aortic dissection (ATAAD). We aimed to explore the preoperative imaging risk findings for postoperative new stroke in patients with ATAAD.Methods: From January 2015 to December 2018, 174 patients with ATAAD who underwent preoperative aortic computed tomography angiography (CTA) and cerebral diffusion-weighted imaging (DWI) as well as postoperative brain CT were included, and divided into DWI (+) and DWI (–) groups. Pre- and intraoperative variables were collected, and logistic regression analysis was used to determine the independent risk predictors of postoperative new stroke.Results: The incidence of postoperative new stroke was 18.4% (32/174) in patients with ATAAD. Postoperative stroke was detected in 13 (31.0%) patients in the DWI (+) group and in 19 (14.4%) patients in the DWI (–) group with significant difference (P = 0.016). In the DWI (+) group, the lesions of the cerebral infarction located in the unilateral cerebral hemisphere and distributed more than three lobes (P = 0.007) were an independent risk factor for postoperative new stroke. Hypotension (P = 0.002), retrograde ascending aorta dissection with thrombosis of the false lumen (P = 0.010), aortic arch entry (P = 0.035), and coronary artery involvement (P = 0.001) were independent risk factors for postoperative stroke in the DWI (–) cohort.Conclusions: Patients with ATAAD with cerebral infarction are more likely to develop postoperative new stroke; thus, a preoperative DWI examination may be necessary. DWI lesions distributed more than 3 lobes in the unilateral hemisphere suggest a high possibility of postoperative stroke. For patients with ATAAD with normal brain, particular attention should be given to the CTA findings of false lumen thrombosis, aortic arch entry, and coronary artery involvement to avoid postoperative stroke.

scholarly journals The Impact of CK-MB Elevation in Patients With Acute Type A Aortic Dissection With Coronary Artery Involvement

2021 ◽  
Author(s):  
Naoshi Minamidate ◽  
Tomoaki Suzuki
Keyword(s):  
Coronary Artery ◽  
Aortic Dissection ◽  
Statistical Significance ◽  
Artery Bypass ◽  
Type A ◽  
Coronary Perfusion ◽  
Acute Type ◽  
Type A Aortic Dissection ◽  
Coronary Artery Involvement ◽  
The Impact

Abstract Background Acute coronary artery involvement (ACI) is a lethal complication of acute type A aortic dissection. Although ACI has been reported as one of the prognostic factors of acute type A aortic dissection, it does not always cause coronary ischemia. The extent of myocardial damage varies from case to case. Moreover, since the definition of ACI varies from paper to paper, it is unknown what the difference is between ACI with and without myocardial necrosis. In general, it can be assumed that cases with myocardial infarction have worse results. However, it is unknown how poor ACI is with myocardiac ischemia and how optimistic it is without it. This study compared the surgical results between the two groups of ACI with or without myocardiac ischemia. Methods Among 348 patients who underwent an emergency operation for acute type A aortic dissection, there were 28 (8.0%) patients complicated by ACI and underwent additional coronary artery bypass grafting. We divided 26 of those patients into two groups; the MI group ( with CK-MB elevation) and the NMI group (without CK-MB elevation) and compared both groups. Results Of the 26, sixteen were in the MI group, and ten were in the NMI group. The average CK-MB in the MI group was 225.5 IU/L, and that in the NMI group was 13.5 IU/L. The mean time from onset to surgery was 248 minutes in the MI group, 250 minutes in the NMI group. There was statistical significance in mortality ( 69% vs. 13%, p=0.03). There was no significance in major complications (ICU days, reintubation, reoperation, pneumonia, sepsis). Conclusions Acute coronary artery involvement was associated with 8.0% of patients with ATAAD, and 62% of them had myocardial ischemia with CK-MB elevation. As expected, the MI group had significantly higher mortality than the NMI group. It is crucial for cases with suspected ACI to obtain coronary perfusion as soon as possible to prevent CK-MB from elevationg.

scholarly journals Long-Term Outcomes of Surgical Treatment for Acute Type-A Aortic Dissection with Coronary Artery Involvement

2021 ◽  
Vol 62 (5) ◽  
pp. 1069-1075
Author(s):  
Shuyang Lu ◽  
Yun Zhao ◽  
Kai Song ◽  
Wangchao Yao ◽  
Le Kang ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Surgical Treatment ◽  
Aortic Dissection ◽  
Type A ◽  
Acute Type ◽  
Long Term Outcomes ◽  
Type A Aortic Dissection ◽  
Coronary Artery Involvement

Characterization of Thromboxane A2/Prostaglandin H2 Receptors in Porcine Coronary Artery -The Inhibitory Effect of a Novel Dibenzoxepin Derivative, KW-3635

1992 ◽  
Vol 67 (05) ◽  
pp. 582-584 ◽  
Author(s):  
Ichiro Miki ◽  
Akio Ishii
Keyword(s):  
Coronary Artery ◽  
Binding Sites ◽  
Thromboxane A2 ◽  
Inhibitory Effect ◽  
Scatchard Analysis ◽  
Single Class ◽  
Porcine Coronary Artery ◽  
Equilibrium Binding ◽  
H2 Receptors

SummaryWe characterized the thromboxane A2/prostaglandin H2 receptors in porcine coronary artery. The binding of [3H]SQ 29,548, a thromboxane A2 antagonist, to coronary arterial membranes was saturable and displaceable. Scatchard analysis of equilibrium binding showed a single class of high affinity binding sites with a dissociation constant of 18.5 ±1.0 nM and the maximum binding of 80.7 ± 5.2 fmol/mg protein. [3H]SQ 29,548 binding was concentration-dependently inhibited by thromboxane A2 antagonists such as SQ 29,548, BM13505 and BM13177 or the thromboxane A2 agonists such as U46619 and U44069. KW-3635, a novel dibenzoxepin derivative, concentration-dependently inhibited the [3H]SQ 29,548 binding to thromboxane A2/prosta-glandin H2 receptors in coronary artery with an inhibition constant of 6.0 ± 0.69 nM (mean ± S.E.M.).

Acute Type-A Aortic Dissection with Obstruction of the Right Coronary Artery

2014 ◽  
Vol 17 (4) ◽  
pp. 196
Author(s):  
Erhan Kaya ◽  
Halit Yerebakan ◽  
Daniel Spielman ◽  
Omer Isik ◽  
Cevat Yakut
Keyword(s):  
Coronary Artery ◽  
Aortic Dissection ◽  
Right Coronary Artery ◽  
Type A ◽  
Sudden Onset ◽  
Acute Type ◽  
Type A Aortic Dissection ◽  
Coronary Syndrome ◽  
Bentall Procedure ◽  
The Right

Occlusion of a coronary artery by an acute type A aortic dissection presents a life-threatening emergency that is rarely seen and easy to misdiagnose. We present the case of a 75-year-old male who experienced sudden onset of severe left-sided chest pain due to an acute type A aortic dissection that obstructed the right coronary artery. Following an initial misdiagnosis of acute coronary syndrome, imaging revealed the presence of an aortic dissection. An emergency modified Bentall procedure was performed, in which the damaged aorta and aortic valve were replaced.

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