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J Thorac Cardiovasc Surg 2008;136:792-793
© 2008 The American Association for Thoracic Surgery

Brief Communication

Intraoperative coronary angiography in the management of patients with acute aortic dissection and endocarditis

^a Department of Cardiac Surgery, University Hospital Grosshadern, Ludwig-Maximilians-University, Munich, Germany
^b Department of Anaesthesiology, University Hospital Grosshadern, Ludwig-Maximilians-University, Munich, Germany

Received for publication October 27, 2007; accepted for publication January 13, 2008.

^_* Address for reprints: Eckehard Kilian, MD, Department of Cardiac Surgery, University Hospital Grosshadern, Ludwig-Maximilians-University, Marchioninistrasse 15, 81377 München, Germany. (Email: Eckehard.Kilian@med.uni-muenchen.de).

The first 20% of the full text of this article appears below.

Early surgical intervention is vital for the treatment of acute aortic dissection and acute aortic valve endocarditis, because interventional delay is associated with increased mortality. Although heart operations should not be performed without knowledge of the current coronary status, preoperative coronary angiography may delay the procedure and entails additional risks for the patient.¹ Furthermore, patients who have aortic valve endocarditis with floating bacterial structures on the valve cusps face an increased risk of coronary ostia embolism during coronary angiography.² Preoperative catheterization in patients with acute aortic dissection may also affect the false lumen or aggravate the dissection, thus increasing perioperative risk.³

We report here the successful use of intraoperative coronary angiography to detect coronary disease in high-risk patients with acute aortic dissection or acute endocarditis.

Clinical Summary

Seven patients with acute aortic dissection of Stanford A type (n = 2) or acute aortic valve endocarditis with valvular vegetations (n = 5) were urgently scheduled for surgical intervention. After . . . [Full Text of this Article]

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