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Follow-up of iatrogenic aorto-coronary "Dunning" dissections by cardiac computed tomography imaging

Stefan Baumann1, Michael Behnes2, Benjamin Sartorius1

  • 1First Department of Medicine, University Medical Centre Mannheim, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.

BMC Medical Imaging
|December 23, 2017
PubMed

Insights

Iatrogenic aorto-coronary dissections, a rare complication of percutaneous coronary interventions (PCI), require timely diagnosis and management. Cardiac computed tomography angiography (cCTA) proves valuable for detecting and monitoring these Dunning dissections.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Medical Imaging

Background:

  • Iatrogenic aorto-coronary dissections are rare but life-threatening complications of percutaneous coronary interventions (PCI).
  • Timely diagnosis and management are crucial for high-risk patients experiencing these dissections.

Purpose of the Study:

  • To describe the in-house experience with diagnosis and therapy of iatrogenic aorto-coronary dissections.
  • To evaluate the role of cardiovascular imaging, specifically cardiac computed tomography angiography (cCTA), in managing patients with Dunning dissections.

Main Methods:

  • Retrospective and observational study design.
  • Included eight patients with iatrogenic Dunning dissections (DD) following routine PCI.
  • Diagnostic assessment, treatment (PCI or conservative), and follow-up utilized coronary angiography and cardiac computed tomography angiography (cCTA).

Main Results:

  • The most common DD type was Type III (50%), often involving the right coronary ostium (88%).
  • 63% of patients were treated with PCI, while others received conservative management.
  • 88% received early cCTA, and 50% had follow-up cCTA within 6 months, showing no residual issues.

Conclusions:

  • Cardiac computed tomography angiography (cCTA) is a valuable imaging modality for detecting Dunning dissections (DD) of all types (I-III).
  • cCTA aids in the secure follow-up of high-risk patients diagnosed with iatrogenic aorto-coronary dissections.
Abstract

Keywords:
Aortocoronary dissectionComplicationCoronary computed tomographyDunningPercutaneous coronary intervention

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