Zachary M. Gertz, MD
Director of Structural Heart Disease, VCU Pauley Heart Center
Assistant Professor, VCU School of Medicine
Because of our center’s high surgical volume with ascending aortic aneurysms, we have performed coronary angiography on a large cohort of these patients. Over time, we came to use a JL catheter that matched the aneurysm size, and had good success. Planning for the right coronary was more difficult, as the catheters were less predictable, although we did find that certain aneurysm locations and shapes conferred a more superior or inferior direction of the coronary artery take-off. We found that there was little in the literature to guide us in approaching this procedure, and that was the impetus for this study.
Also of interest was the incidence of coronary artery disease. An interesting comparison is with patients with abdominal aortic aneurysms, about whom more is known in terms of risk factors and disease presence. Ascending aneurysms arise from a different pathophysiology than abdominal aortic aneurysms, which typically occur because of atherosclerotic vessel destruction. A low incidence of coronary disease in the ascending aneurysm population might argue against routine catheterization. Yet the incidence of coronary disease was not trivial. As long as a sternotomy is part of the operative procedure for ascending aortic aneurysm repair, we feel that the relative ease of catheterization, coupled with the prevalence of coronary disease, justify the continued practice of preoperative catheterization in this population.
Full article available at:
- Gertz ZM, Levitt SA, Epps, KC, et al. Cardiac Catheterization in Patients With Ascending Aortic Aneurysms: Safety, Success, and Prevalence of Coronary Artery Disease. J Invasive Cardiol. 2014;26(6):241-244.
A selection of articles on Cardiac Imaging:
- Kim SW1, Mintz GS, Weissman NJ, et al. Frequency and evolution of thin-capped fibroatheromas in left main coronary artery as assessed by serial virtual histology intravascular ultrasound analysis. J Invasive Cardiol. 2014 Apr;26(4):175-179.
- Kiemeneij F. Simultaneous transradial coronary angioplasty and contralateral coronary angiography with a single guide catheter for total coronary occlusions. J Invasive Cardiol. 2014 Feb;26(2):87-90.
- Madder RD, Wohns DH, Muller JE. Detection by Intracoronary Near-Infrared Spectroscopy of Lipid Core Plaque at Culprit Sites in Survivors of Cardiac Arrest. J Invasive Cardiol. 2014 Feb;26(2):78-79.
- Hao R, Zhang Q, Xu Z, et al. Magnetic Navigation System and CT Roadmap-Assisted Percutaneous Coronary Intervention: A Comparison to the Conventional Approach. J Invasive Cardiol. 2013 Apr;25(4):177-181.