having had a dissected aorta at the arch, is there a greater danger involved in having an angiogram than in ordinary circumstances?
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This is an interesting question that you raise. Often when patients present with a life-threatening acute dissection of the ascending aorta, the cardiothoracic surgeons require an emergency coronary angiogram to define the pressence and extent of coronary artery disease before they take these patients to the operating room. The risk of entering a false plain and worsening the dissection is considerably higher than in the absence of a dissection, however with careful wire and catheter manipulations, an angiogram can still be performed safely. In your case, if the arch dissection is chronic, the risk of entering the false lumen is relatively low provided the operator is experienced and aware of the dissection.
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Cardiology Online: Served by - S. Leslie Tobias, MD, FACC, FSCAI
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