Percutaneous coronary intervention for left main coronary artery malperfusion in acute type A aortic dissection View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2021-07-13

AUTHORS

Yuya Taguchi, Shunsuke Kubo, Akihiro Ikuta, Kohei Osakada, Makoto Takamatsu, Kotaro Takahashi, Masanobu Ohya, Takenobu Shimada, Katsuya Miura, Ryosuke Murai, Takeshi Tada, Hiroyuki Tanaka, Yasushi Fuku, Tsuyoshi Goto, Tatsuhiko Komiya, Kazushige Kadota

ABSTRACT

The clinical outcomes of patients undergoing percutaneous coronary intervention (PCI) for left main coronary artery (LMCA) malperfusion caused by acute type A aortic dissection (AAAD) remains largely unexplored. The aim of this study was to determine the clinical outcomes of patients undergoing PCI for LMCA malperfusion caused by AAAD. We examined nine consecutive patients undergoing PCI for LMCA malperfusion caused by AAAD between 1995 and 2020. The mean age was 55.4 ± 7.7 years. Eight patients presented cardiogenic shock, and five patients cardiopulmonary arrest. Two patients were diagnosed with AAAD before coronary angiography using computed tomography and transthoracic echocardiography, respectively, and in the other seven patients after coronary angiography using other modalities. Four patients underwent PCI on intra-aortic balloon pumping support, and four patients on venoarterial extracorporeal membrane oxygenation (VA-ECMO) support, including one patient on both. PCI was successful in eight patients, with final thrombolysis in myocardial infarction grade 2 or 3. The four patients on VA-ECMO did not undergo aortic dissection repair due to poor recovery of cardiac function and died during the hospital stay, and the other five patients had successful PCI, underwent aortic dissection repair, and remained alive at 5 year follow-up. In conclusion, LMCA malperfusion caused by AAAD seemed to have clinical presentations and electrocardiogram changes similar to acute coronary syndrome. PCI and subsequent surgical aortic repair saved the lives of all AAAD patients with LMCA malperfusion who had not required VA-ECMO. More... »

PAGES

333-342

References to SciGraph publications

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s12928-021-00793-4

DOI

http://dx.doi.org/10.1007/s12928-021-00793-4

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1139663110

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/34255294


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17 schema:description The clinical outcomes of patients undergoing percutaneous coronary intervention (PCI) for left main coronary artery (LMCA) malperfusion caused by acute type A aortic dissection (AAAD) remains largely unexplored. The aim of this study was to determine the clinical outcomes of patients undergoing PCI for LMCA malperfusion caused by AAAD. We examined nine consecutive patients undergoing PCI for LMCA malperfusion caused by AAAD between 1995 and 2020. The mean age was 55.4 ± 7.7 years. Eight patients presented cardiogenic shock, and five patients cardiopulmonary arrest. Two patients were diagnosed with AAAD before coronary angiography using computed tomography and transthoracic echocardiography, respectively, and in the other seven patients after coronary angiography using other modalities. Four patients underwent PCI on intra-aortic balloon pumping support, and four patients on venoarterial extracorporeal membrane oxygenation (VA-ECMO) support, including one patient on both. PCI was successful in eight patients, with final thrombolysis in myocardial infarction grade 2 or 3. The four patients on VA-ECMO did not undergo aortic dissection repair due to poor recovery of cardiac function and died during the hospital stay, and the other five patients had successful PCI, underwent aortic dissection repair, and remained alive at 5 year follow-up. In conclusion, LMCA malperfusion caused by AAAD seemed to have clinical presentations and electrocardiogram changes similar to acute coronary syndrome. PCI and subsequent surgical aortic repair saved the lives of all AAAD patients with LMCA malperfusion who had not required VA-ECMO.
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23 schema:keywords AAAD
24 AAAD patients
25 Myocardial Infarction grade 2
26 VA-ECMO
27 acute coronary syndrome
28 acute type
29 age
30 aim
31 angiography
32 aortic dissection
33 aortic dissection repair
34 aortic repair
35 arrest
36 balloon
37 cardiac function
38 cardiogenic shock
39 cardiopulmonary arrest
40 changes
41 clinical outcomes
42 clinical presentation
43 conclusion
44 consecutive patients
45 coronary angiography
46 coronary artery malperfusion
47 coronary intervention
48 coronary syndrome
49 dissection
50 dissection repair
51 echocardiography
52 electrocardiogram changes
53 extracorporeal membrane oxygenation support
54 final Thrombolysis
55 function
56 grade 2
57 hospital stay
58 intervention
59 intra-aortic balloon
60 life
61 malperfusion
62 mean age
63 membrane oxygenation support
64 modalities
65 outcomes
66 oxygenation support
67 patients
68 percutaneous coronary intervention
69 poor recovery
70 presentation
71 recovery
72 repair
73 shock
74 stay
75 study
76 successful percutaneous coronary intervention
77 support
78 surgical aortic repair
79 syndrome
80 thrombolysis
81 tomography
82 transthoracic echocardiography
83 types
84 venoarterial extracorporeal membrane oxygenation support
85 years
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