Related Experiment Video

Updated: Aug 29, 2026

Novel and Innovative Hybrid Technique for Type A Aortic Dissection
06:26

Novel and Innovative Hybrid Technique for Type A Aortic Dissection

Published on: March 28, 2025

The role of coronary angiography in acute type A aortic dissection

Reza Motallebzadeh1, Divna Batas, Oswaldo Valencia

  • 1Department of Cardiac Surgery, St George's Hospital and Medical School, Blackshaw Road, SW17 0QT, London, UK.

European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery
|January 30, 2004
PubMed

Insights

Coronary angiography does not improve survival in acute aortic dissection and delays surgery. This study suggests avoiding angiography in these patients to ensure timely treatment and better outcomes.

Area of Science:

  • Cardiovascular Surgery
  • Diagnostic Imaging
  • Emergency Medicine

Background:

  • Non-invasive imaging is now standard for diagnosing aortic dissection.
  • Coronary angiography may be used to assess for coronary artery disease (CAD), potentially delaying critical surgery and increasing rupture risk.

Purpose of the Study:

  • To evaluate the role and impact of coronary angiography in patients with acute aortic dissection.
  • To determine if angiography influences the need for coronary artery bypass grafting (CABG), surgical delay, and patient outcomes.

Main Methods:

  • Retrospective analysis of 74 patients undergoing acute aortic dissection repair (1992-2002).
  • Comparison of outcomes between patients who underwent angiography (Group I) and those who did not (Group II).
  • Analysis of factors including concomitant CABG, surgical delay, and mortality.

Main Results:

  • Angiography (31% of patients) did not impact the rate of CABG or improve hospital survival.
  • Patients undergoing angiography experienced significantly longer delays to surgery (median 5h vs 1.5h).
  • Higher mortality was observed in patients undergoing CABG and those presenting with syncope or hypotension.

Conclusions:

  • Coronary angiography is not recommended in acute aortic dissection due to lack of benefit and significant surgical delays.
  • Avoiding angiography can facilitate prompt surgical intervention, potentially improving outcomes in acute aortic dissection.
Abstract

More Related Videos

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function10:28

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function

Published on: March 15, 2022

Related Concept Videos

Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
Aneurysm II: Clinical Manifestations and Diagnostic Studies01:21

Aneurysm II: Clinical Manifestations and Diagnostic Studies

Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
Aortic Regurgitation II: Clinical Features and Diagnostic Tests01:22

Aortic Regurgitation II: Clinical Features and Diagnostic Tests

Aortic valve regurgitation (AR) occurs when the aortic valve fails to close properly, allowing blood to flow backward from the aorta into the left ventricle. This backflow can result in two distinct clinical presentations: acute and chronic AR, each characterized by its own set of symptoms and physical findings.Acute Aortic RegurgitationAcute AR presents with a sudden onset of severe symptoms. Patients typically experience profound dyspnea (shortness of breath), chest pain, and signs of left...
Acute Coronary Syndrome I: Introduction01:30

Acute Coronary Syndrome I: Introduction

Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
Coronary Artery Disease V: Interprofessional Care01:27

Coronary Artery Disease V: Interprofessional Care

Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...
Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations01:19

Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations

The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...