Skip to main content
Top
Published in: Indian Journal of Thoracic and Cardiovascular Surgery 1/2022

01-04-2022 | Aortic Aneurysm | Review Article

Coronary artery disease in aortic aneurysm and dissection

Authors: Joon Chul Jung, Kay-Hyun Park

Published in: Indian Journal of Thoracic and Cardiovascular Surgery | Special Issue 1/2022

Login to get access

Abstract

Coexisting coronary artery disease is a significant risk factor of untoward outcomes after surgical and endovascular aortic repair. This article reviewed the data, consensus, and remaining controversy about the diagnosis and management of coexisting coronary artery disease in the patients who require intervention for aortic aneurysm and dissection. It can be summarized as follows: (1) the current guidelines generally recommend the same diagnostic algorithm, including indications of coronary artery angiography, as one for non-surgical patients; (2) they also recommend the same indications of coronary revascularization; and (3) there are minor, but important, remaining issues regarding the details of management and surgical techniques most of which are still at the discretion of individual surgeons and institutions. Because it is not likely to get large-scale investigational data about these issues, the collection of individual experiences should be promoted in future scientific meetings to build up the consensus.
Literature
3.
go back to reference Van Kuijk JP, Flu WJ, Dunckelgrun M, Bax JJ, Poldermans D. Coronary artery disease in patients with abdominal aortic aneurysm: a review article. J Cardiovasc Surg (Torino). 2009;50:93–107. Van Kuijk JP, Flu WJ, Dunckelgrun M, Bax JJ, Poldermans D. Coronary artery disease in patients with abdominal aortic aneurysm: a review article. J Cardiovasc Surg (Torino). 2009;50:93–107.
6.
go back to reference Kieffer E, Chiche L, Baron JF, Godet G, Koskas F, Bahnini A. Coronary and carotid artery disease in patients with degenerative aneurysm of the descending thoracic or thoracoabdominal aorta: prevalence and impact on operative mortality. Ann Vasc Surg. 2002;16:679–84. https://doi.org/10.1007/s10016-001-0315-1. Kieffer E, Chiche L, Baron JF, Godet G, Koskas F, Bahnini A. Coronary and carotid artery disease in patients with degenerative aneurysm of the descending thoracic or thoracoabdominal aorta: prevalence and impact on operative mortality. Ann Vasc Surg. 2002;16:679–84. https://​doi.​org/​10.​1007/​s10016-001-0315-1.
7.
go back to reference Islamoğlu F, Atay Y, Can L, et al. Diagnosis and treatment of concomitant aortic and coronary disease: a retrospective study and brief review. Tex Heart Inst J. 1999;26:182–8.PubMedPubMedCentral Islamoğlu F, Atay Y, Can L, et al. Diagnosis and treatment of concomitant aortic and coronary disease: a retrospective study and brief review. Tex Heart Inst J. 1999;26:182–8.PubMedPubMedCentral
9.
go back to reference Creswell LL, Kouchoukos NT, Cox JL, Rosenbloom M. Coronary artery disease in patients with type A aortic dissection. Ann Thorac Surg. 1995;59:585–90.CrossRef Creswell LL, Kouchoukos NT, Cox JL, Rosenbloom M. Coronary artery disease in patients with type A aortic dissection. Ann Thorac Surg. 1995;59:585–90.CrossRef
13.
go back to reference Khan FM, Naik A, Hameed I, et al. Open repair of descending thoracic and thoracoabdominal aortic aneurysms: a meta-analysis. Ann Thorac Surg. 2020;110:1941–9.CrossRef Khan FM, Naik A, Hameed I, et al. Open repair of descending thoracic and thoracoabdominal aortic aneurysms: a meta-analysis. Ann Thorac Surg. 2020;110:1941–9.CrossRef
15.
16.
go back to reference Kristensen SD, Knuuti J, Saraste A, et al. 2014 ESC/ESA Guidelines on non-cardiac surgery: cardiovascular assessment and management: the Joint Task Force on non-cardiac surgery: cardiovascular assessment and management of the European Society of Cardiology (ESC) and the European Society of Anaesthesiology (ESA). Eur Heart J. 2014;35:2383–431. https://doi.org/10.1093/eurheartj/ehu282.CrossRefPubMed Kristensen SD, Knuuti J, Saraste A, et al. 2014 ESC/ESA Guidelines on non-cardiac surgery: cardiovascular assessment and management: the Joint Task Force on non-cardiac surgery: cardiovascular assessment and management of the European Society of Cardiology (ESC) and the European Society of Anaesthesiology (ESA). Eur Heart J. 2014;35:2383–431. https://​doi.​org/​10.​1093/​eurheartj/​ehu282.CrossRefPubMed
17.
go back to reference Fleisher LA, Fleischmann KE, Auerbach AD, et al. 2014 ACC/AHA guideline on perioperative cardiovascular evaluation and management of patients undergoing noncardiac surgery: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2014;130:2215–2245. Fleisher LA, Fleischmann KE, Auerbach AD, et al. 2014 ACC/AHA guideline on perioperative cardiovascular evaluation and management of patients undergoing noncardiac surgery: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2014;130:2215–2245.
20.
go back to reference Schouten O, van Kuijk JP, Flu WJ, et al. Long-term outcome of prophylactic coronary revascularization in cardiac high-risk patients undergoing major vascular surgery (from the randomized DECREASE-V Pilot Study). Am J Cardiol. 2009;103:897–901.CrossRef Schouten O, van Kuijk JP, Flu WJ, et al. Long-term outcome of prophylactic coronary revascularization in cardiac high-risk patients undergoing major vascular surgery (from the randomized DECREASE-V Pilot Study). Am J Cardiol. 2009;103:897–901.CrossRef
21.
go back to reference Dewey M, Rief M, Martus P, et al. Evaluation of computed tomography in patients with atypical angina or chest pain clinically referred for invasive coronary angiography: randomised controlled trial. BMJ. 2016;355:i5441. https://doi.org/10.1136/bmj.i5441. Dewey M, Rief M, Martus P, et al. Evaluation of computed tomography in patients with atypical angina or chest pain clinically referred for invasive coronary angiography: randomised controlled trial. BMJ. 2016;355:i5441. https://​doi.​org/​10.​1136/​bmj.​i5441.
22.
go back to reference Chang HJ, Lin FY, Gebow D, et al. Selective referral using CCTA versus direct referral for individuals referred to invasive coronary angiography for suspected CAD: a randomized, controlled, open-label trial. JACC Cardiovasc Imaging. 2019;12:1303–12.CrossRef Chang HJ, Lin FY, Gebow D, et al. Selective referral using CCTA versus direct referral for individuals referred to invasive coronary angiography for suspected CAD: a randomized, controlled, open-label trial. JACC Cardiovasc Imaging. 2019;12:1303–12.CrossRef
23.
go back to reference Douglas PS, Hoffmann U, Patel MR, et al. Outcomes of anatomical versus functional testing for coronary artery disease. N Engl J Med. 2015;372:1291–300.CrossRef Douglas PS, Hoffmann U, Patel MR, et al. Outcomes of anatomical versus functional testing for coronary artery disease. N Engl J Med. 2015;372:1291–300.CrossRef
24.
go back to reference Jørgensen ME, Andersson C, Nørgaard BL, et al. Functional testing or coronary computed tomography angiography in patients with stable coronary artery disease. J Am Coll Cardiol. 2017;69:1761–70.CrossRef Jørgensen ME, Andersson C, Nørgaard BL, et al. Functional testing or coronary computed tomography angiography in patients with stable coronary artery disease. J Am Coll Cardiol. 2017;69:1761–70.CrossRef
29.
34.
35.
go back to reference Valgimigli M, Bueno H, Byrne RA, et al. 2017 ESC focused update on dual antiplatelet therapy in coronary artery disease developed in collaboration with EACTS: the Task Force for dual antiplatelet therapy in coronary artery disease of the European Society of Cardiology (ESC) and of the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J. 2018;39:213–60. https://doi.org/10.1093/eurheartj/ehx419.CrossRefPubMed Valgimigli M, Bueno H, Byrne RA, et al. 2017 ESC focused update on dual antiplatelet therapy in coronary artery disease developed in collaboration with EACTS: the Task Force for dual antiplatelet therapy in coronary artery disease of the European Society of Cardiology (ESC) and of the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J. 2018;39:213–60. https://​doi.​org/​10.​1093/​eurheartj/​ehx419.CrossRefPubMed
37.
go back to reference Mannacio VA, Mannacio L, Monaco M, et al. Safety of aortic aneurysm repair 8 weeks after percutaneous coronary intervention for coronary artery disease: a cohort study. Updates Surg. 2020;72:1213–21. Mannacio VA, Mannacio L, Monaco M, et al. Safety of aortic aneurysm repair 8 weeks after percutaneous coronary intervention for coronary artery disease: a cohort study. Updates Surg. 2020;72:1213–21.
40.
45.
52.
go back to reference Hansson EC, Geirsson A, Hjortdal V, et al. Preoperative dual antiplatelet therapy increases bleeding and transfusions but not mortality in acute aortic dissection type A repair. Eur J Cardiothorac Surg. 2019;56:182–188. https://doi.org/10.1093/ejcts/ezy469. Hansson EC, Geirsson A, Hjortdal V, et al. Preoperative dual antiplatelet therapy increases bleeding and transfusions but not mortality in acute aortic dissection type A repair. Eur J Cardiothorac Surg. 2019;56:182–188. https://​doi.​org/​10.​1093/​ejcts/​ezy469.
55.
go back to reference Cabrol C, Pavie A, Gandjbakhch I, et al. Complete replacement of the ascending aorta with reimplantation of the coronary arteries: new surgical approach. J Thorac Cardiovasc Surg. 1981;81:309–15.CrossRef Cabrol C, Pavie A, Gandjbakhch I, et al. Complete replacement of the ascending aorta with reimplantation of the coronary arteries: new surgical approach. J Thorac Cardiovasc Surg. 1981;81:309–15.CrossRef
Metadata
Title
Coronary artery disease in aortic aneurysm and dissection
Authors
Joon Chul Jung
Kay-Hyun Park
Publication date
01-04-2022
Publisher
Springer Singapore
Published in
Indian Journal of Thoracic and Cardiovascular Surgery / Issue Special Issue 1/2022
Print ISSN: 0970-9134
Electronic ISSN: 0973-7723
DOI
https://doi.org/10.1007/s12055-021-01265-3

Other articles of this Special Issue 1/2022

Indian Journal of Thoracic and Cardiovascular Surgery 1/2022 Go to the issue