Structural Features of the Sinus of Valsalva and the Proximal Portion of the Coronary Arteries: Their Relevance to Retrograde Aortocoronary Dissection

López-Mínguez, José Ramón; Climent, Vicente; Yen-Ho, Siew; González-Fernández, Reyes; Nogales-Asensio, Juan Manuel; Sánchez‐Quintana, Damián

doi:10.1016/s1885-5857(07)60028-0

Cited by 17 publications

(15 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…1 Dissection of the right coronary artery (87%) occurs more frequently than left coronary artery (13%) and in at least twothirds of the cases described, dissection occurs when injecting contrast agents. 2 In our patient, the catheter tip being seated in a plaque and the forceful prolonged injection of contrast could have contributed to proximal right coronary dissection with the dissection plane extending retrogradely into the aorta. On reviewing the literature, over 80 case reports of aortocoronary dissections occurring during coronary angiography have been published.…”

Section: Discussionmentioning

confidence: 74%

Iatrogenic Aortocoronary Dissection Successfully Treated by Coronary Intervention

Attar

Bury

Galasko

2011

Heart International

View full text Add to dashboard Cite

A 77-year old male retired decorator presented with an 18-month history of exertional dyspnea. Coronary angiography was performed via the right femoral artery using 6 French JL4 and JR4 diagnostic catheters. A catheter possibly seated in a plaque caused dissection of the right coronary artery with the injection of the contrast. Timely coronary intervention with stenting resulted in sealing the entry point with complete healing of the aortic root and TIMI-3 patency of the right coronary artery. Major cardiac surgery was, therefore, averted.

show abstract

Section: Discussionmentioning

confidence: 74%

Iatrogenic Aortocoronary Dissection Successfully Treated by Coronary Intervention

Attar

Bury

Galasko

2011

Heart International

View full text Add to dashboard Cite

show abstract

“…The wall of the sinuses is thinner than that of the ascending aorta and its thickness decreases progressively as it approaches the aorto-ventricular junction. 16 The sinuses of Valsalva play no direct role in valve competence, which is why isolated sinus aneurysms do not typically cause AI. However, through the creation of eddy currents, the sinuses play an important role in minimizing stress on the cusps and in optimizing coronary blood flow reserve, especially in systole.…”

Section: Anatomy and Physiology Of The Aortic Rootmentioning

confidence: 99%

Predictors of Aortic Valve Repair Failure

Yanagawa

Mazine

El-Hamamsy

2019

Innovations�(Phila)

View full text Add to dashboard Cite

Aortic valve repair is the preferred approach for the treatment of severe aortic insufficiency (AI), as it allows patients to keep their native aortic valve, thus substantially reducing the risk of prosthesis-related complications. Several studies have documented excellent long-term outcomes of aortic valve repair. The major complication of this operation is AI recurrence, with ensuingneed for reoperation. The surgical experience accumulated over the last two decades has allowed for better understanding of the mechanisms of recurrent AI after aortic valve repair. Herein, we review the current state of knowledge on predictors of aortic valve repair failure. These include unaddressed annular dilation, residual cusp prolapse or retraction, commissural orientation, and use of patch material. This enhanced understanding has led to the development of increasingly refined techniques and improved patient outcomes. Continued follow-up and detailed data collection at the time of surgery, together with three-dimensional echo imaging, will allow further improvements in aortic valve repair.

show abstract

“…It is more often observed in the right coronary artery due to its smaller ostium, a more variable coronary take‐off, and the presence of a conus artery that may arise directly off the right coronary cusp. Moreover, the right coronary sinus has different histological properties with a lower tensile strength and is, therefore, more prone to traction and subsequent IACD 4 …”

Section: Introductionmentioning

confidence: 99%

Iatrogenic aorta‐coronary dissection: Case report and systematic review

Cereda

Toselli

Khokhar

et al. 2020

Cathet Cardio Intervent

View full text Add to dashboard Cite

Objectives and Background Iatrogenic aorto‐coronary dissection (ICD) is one of the most feared complications of interventional cardiology. Although rare, it is characterized by anterograde coronary ischemia and a concomitant aortic dissection, with potentially fatal consequences. Methods We present an example case of IACD and an accurate case‐series review of the literature including 125 published cases. Results There were no significant predisposing factors and the IACD occurred equally in elective and urgent procedures. A significant number of IACDs were associated with CTO procedures. The factors associated with a worse outcome were hemodynamic instability, the presence of anterograde ischemia, and the extent of dissection according to the Dunning classification. Bail‐out stenting was the most used strategy and its failure was associated with mortality. Conclusion The main features of IACD are anterograde ischemia, retrograde dissection, and hemodynamic instability, each of them should be addressed with no time delay, possibly with bailout stenting, the most employed exit‐strategy. According to our proposed algorithm, a shock team approach is required to coordinate the interdisciplinary skills and enabled patients to receive the best treatment.

show abstract

Structural Features of the Sinus of Valsalva and the Proximal Portion of the Coronary Arteries: Their Relevance to Retrograde Aortocoronary Dissection

Cited by 17 publications

References 15 publications

Iatrogenic Aortocoronary Dissection Successfully Treated by Coronary Intervention

Iatrogenic Aortocoronary Dissection Successfully Treated by Coronary Intervention

Predictors of Aortic Valve Repair Failure

Iatrogenic aorta‐coronary dissection: Case report and systematic review

Contact Info

Product

Resources

About