Coronary malperfusion due to type a aortic dissection: mechanism and surgical management

Kawahito, Koji; Adachi, Hideo; Murata, Shigeo; Yamaguchi, Atsushi; Ichihara, T.

doi:10.1016/s0003-4975(03)00899-3

Cited by 142 publications

(140 citation statements)

References 14 publications

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“…However, AAD with coronary artery malperfusion is fatal because of the diffi culty in making an accurate diagnosis and administering an appropriate treatment. The incidence of coronary malperfusion ranges from 6% to 11% in clinical reports 1,2) and 7% in an autopsy report 3) . The reported hospital mortality rate of an aortic dissection with coronary malperfusion is extremely high at 33.3% 1) .…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of coronary malperfusion ranges from 6% to 11% in clinical reports 1,2) and 7% in an autopsy report 3) . The reported hospital mortality rate of an aortic dissection with coronary malperfusion is extremely high at 33.3% 1) . Even though several case reports in which this condi- ─ 249 ─ Intraoperative TEE is also very useful for estimating both cardiac function and valve function 4) .…”

Section: Discussionmentioning

confidence: 99%

“…However, acute myocardial ischemia associated with aortic dissection is relatively rare and results in a critical condition of the patient [1][2][3] .…”

Section: Introductionmentioning

confidence: 99%

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Acute Type A Aortic Dissection Involving Malperfusion of Bilateral Coronary Arteries

et al. 2017

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Acute Type A Aortic Dissection Involving Malperfusion of Bilateral Coronary Arteries

et al. 2017

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“…Several case reports of a Stanford type A aortic dissection in combination with a myocardial infarction have been published. [1][2][3][4][5][6][7] In almost all cases the right coronary artery was involved. [1][2][3] We report a case of anterior myocardial infarction due to a Stanford type A aortic dissection involving the left main trunk of the coronary artery.…”

Section: Discussionmentioning

confidence: 99%

Acute myocardial infarction due to an acute type A aortic dissection involving the left main coronary artery

Zegers¹,

Gehlmann²,

Verheugt³

2007

NHJL

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Acute myocardial infarction due to an acute type A aortic dissection involving the left main coronary arteryWe report a case of anterior myocardial infarction due to a Stanford type A aortic dissection involving the left main trunk of the coronary artery. Acute myocardial infarction due to extension of an acute Stanford type A aortic dissection is an infrequent but devastating situation. In our case a spontaneous aortocoronary dissection involving the Valsalva sinus and the ascending aorta with a history of hypertension is the most plausible cause. Emergent aortic replacement and revascularisation was performed. (Neth Heart J 2007;15:263-4.)

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“…13 The mortality rates of AAD complicated with ACS and of AAD alone reported by Kawada et al are 53% and 19%, respectively, 30 and those reported by Kawahito et al are 33% and 8.8%, respectively. 31 Both reports show significantly higher mortality rates among patients with complications than in those without. In the present study, 3 of 8 patients who had AAD with ACS died, giving a mortality rate of 38%.…”

Section: Characteristics Of Aad Complicated By Acsmentioning

confidence: 97%

Diagnostic Score to Differentiate Acute Aortic Dissection in the Emergency Room

Shirakabe

Hata

Yokoyama

et al. 2008

Circ J

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cute aortic dissection (AAD) and acute coronary syndrome (ACS) are life-threatening cardiovascular emergencies that can be difficult to differentiate in the emergency room (ER), particularly if ACS is complicated with AAD, in which case the clinical signs of AAD may be overlooked. The diagnosis in the ER will affect the choice of treatment and, therefore, prognosis.Electrocardiography, cardiac ultrasonography, and myocardial markers can diagnose ACS, but the clinical symptoms and signs of AAD can be confusing. Enhanced computed tomography (CT) is valuable for diagnosis when AAD is suspected in the ER, although the rate of correct diagnosis has been reported as 40-74%. 1,2 Because AAD progresses to fatal complications within the first 48 h, mortality rates increase at the rate of 1-2% per hour. Other reports have indicated a 9-39% perioperative mortality rate for type-A AAD. [3][4][5] Thus, the correct differential diagnosis of AAD and ACS in the ER is critical 6,7 and the goal of the present study was to establish a diagnostic standard (ERAAD score) by clarifying information that is specific to AAD. Methods Study DesignStudy 1 In order to define the features of AAD and ACS we evaluated 131 patients with AAD or ACS who were admitted between April 2001 and March 2002. The clinical information included age, gender, presence of back pain, systolic and diastolic blood pressures (BP), serum creatine kinase level, ST-T segment changes on electrocardiograms (ECG), mediastinum thoracic ratio (MTR; Fig 1) and cardiothoracic ratio (CTR) on chest X-rays, and aortic regurgitation (AR) and aortic diameter on cardiac ultrasonograms, as well as history of smoking, hypertension, hyperlipidemia or diabetes mellitus. We scored the total number of indexes specific to AAD for each patient to obtain the ERAAD score. J 2008; 72: 986 -990 (Received October 20, 2007; revised manuscript received January 8, 2008; accepted January 17, 2008 Circ

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Coronary malperfusion due to type a aortic dissection: mechanism and surgical management

Cited by 142 publications

References 14 publications

Acute Type A Aortic Dissection Involving Malperfusion of Bilateral Coronary Arteries

Acute Type A Aortic Dissection Involving Malperfusion of Bilateral Coronary Arteries

Acute myocardial infarction due to an acute type A aortic dissection involving the left main coronary artery

Diagnostic Score to Differentiate Acute Aortic Dissection in the Emergency Room

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