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Iatrogenic Catheter-Induced Acute Aortic Dissection Type A after Coronary Angiography-A Retrospective Consecutive

Katharina Huenges1, Jan Dreyer1, Bernd Panholzer1

  • 1Department of Cardiovascular Surgery, University of Schleswig-Holstein Campus Kiel, Kiel, Germany.

The Thoracic and Cardiovascular Surgeon
|December 14, 2016
PubMed

Insights

Catheter-induced acute aortic dissection type A (ciAADA) is a rare but severe complication of coronary angiography. Patients with ciAADA face higher mortality rates due to pre-existing conditions and procedural complications.

Area of Science:

  • Cardiovascular Surgery
  • Interventional Cardiology
  • Vascular Surgery

Background:

  • Acute aortic dissection type A (AADA) is a life-threatening condition requiring complex surgical intervention.
  • While typically spontaneous, AADA can arise as a complication of interventional procedures like coronary angiography.

Purpose of the Study:

  • To analyze the characteristics and outcomes of patients who developed catheter-induced AADA (ciAADA) following coronary angiography.
  • To compare the clinical presentation, surgical management, and mortality of ciAADA patients with the general AADA population.

Main Methods:

  • Retrospective analysis of 14 patients surgically treated for ciAADA between 2004 and 2014.
  • Comparison of ciAADA patient data with a cohort of 288 overall AADA patients from the same period.

Main Results:

  • ciAADA patients were older, more frequently hemodynamically unstable, and required mechanical ventilation upon admission.
  • Surgical procedures for ciAADA involved longer cardiopulmonary bypass and cross-clamp times, often necessitating coronary artery bypass grafting due to myocardial ischemia.
  • ciAADA patients exhibited significantly higher 30-day mortality (50.0% vs. 10.7%) compared to the general AADA group.

Conclusions:

  • Coronary angiography-induced AADA is a rare but serious complication with a poorer prognosis.
  • Preoperative hemodynamic instability and the need for additional procedures contribute to the adverse outcomes observed in ciAADA patients.

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