Case Report: Diagnostic and therapeutic challenges in acute myocardial infarction years after aortic replacement surgery: a case of severe vascular tortuosity
This study delineates the diagnostic and therapeutic strategies for acute myocardial infarction occurring years after stent implantation for Stanford type A aortic dissection. Emergency coronary angiography presented substantial technical challenges attributable to the lack of recent aortic imaging...
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| Language: | English |
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Frontiers Media S.A.
2025-06-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2025.1611019/full |
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| author | Yuanzhen Su Gaixia Zhai Lei Zhang Hongliang Tian |
| author_facet | Yuanzhen Su Gaixia Zhai Lei Zhang Hongliang Tian |
| author_sort | Yuanzhen Su |
| collection | DOAJ |
| description | This study delineates the diagnostic and therapeutic strategies for acute myocardial infarction occurring years after stent implantation for Stanford type A aortic dissection. Emergency coronary angiography presented substantial technical challenges attributable to the lack of recent aortic imaging data and marked tortuosity of the brachiocephalic trunk resulting from postoperative anatomical changes. Consequently, while selective left coronary angiography was successfully completed, visualization of the right coronary artery necessitated non-selective contrast administration via a pigtail catheter. This case underscores the pivotal role of preoperative aortic computed tomography angiography (CTA) in hemodynamically stable patients, as it provides essential vascular anatomical information that may circumvent procedural complexities during coronary angiography. Building upon these observations, we advocate an “aorto-coronary combined assessment” strategy for post-aortic surgery patients, integrating systematic imaging surveillance to facilitate early identification of coronary lesions. Such an approach permits the timely implementation of intensive medical therapy or elective revascularization, thereby mitigating the risk of acute cardiovascular events. |
| format | Article |
| id | doaj-art-53b3608c7aaf4da7b42c2f468ec7ff43 |
| institution | DOAJ |
| issn | 2297-055X |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj-art-53b3608c7aaf4da7b42c2f468ec7ff432025-08-20T03:07:51ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2025-06-011210.3389/fcvm.2025.16110191611019Case Report: Diagnostic and therapeutic challenges in acute myocardial infarction years after aortic replacement surgery: a case of severe vascular tortuosityYuanzhen Su0Gaixia Zhai1Lei Zhang2Hongliang Tian3Department of Cardiology, Zibo Central Hospital, Zibo, ChinaDepartment of Ophthalmology, Zibo Central Hospital, Zibo, ChinaDepartment of Cardiology, Zibo Central Hospital, Zibo, ChinaDepartment of Cardiology, Zibo Central Hospital, Zibo, ChinaThis study delineates the diagnostic and therapeutic strategies for acute myocardial infarction occurring years after stent implantation for Stanford type A aortic dissection. Emergency coronary angiography presented substantial technical challenges attributable to the lack of recent aortic imaging data and marked tortuosity of the brachiocephalic trunk resulting from postoperative anatomical changes. Consequently, while selective left coronary angiography was successfully completed, visualization of the right coronary artery necessitated non-selective contrast administration via a pigtail catheter. This case underscores the pivotal role of preoperative aortic computed tomography angiography (CTA) in hemodynamically stable patients, as it provides essential vascular anatomical information that may circumvent procedural complexities during coronary angiography. Building upon these observations, we advocate an “aorto-coronary combined assessment” strategy for post-aortic surgery patients, integrating systematic imaging surveillance to facilitate early identification of coronary lesions. Such an approach permits the timely implementation of intensive medical therapy or elective revascularization, thereby mitigating the risk of acute cardiovascular events.https://www.frontiersin.org/articles/10.3389/fcvm.2025.1611019/fullStanford type A aortic dissectionaortic computed tomography angiographycoronary artery diseaseacute myocardial infarctioncoronary angiography |
| spellingShingle | Yuanzhen Su Gaixia Zhai Lei Zhang Hongliang Tian Case Report: Diagnostic and therapeutic challenges in acute myocardial infarction years after aortic replacement surgery: a case of severe vascular tortuosity Frontiers in Cardiovascular Medicine Stanford type A aortic dissection aortic computed tomography angiography coronary artery disease acute myocardial infarction coronary angiography |
| title | Case Report: Diagnostic and therapeutic challenges in acute myocardial infarction years after aortic replacement surgery: a case of severe vascular tortuosity |
| title_full | Case Report: Diagnostic and therapeutic challenges in acute myocardial infarction years after aortic replacement surgery: a case of severe vascular tortuosity |
| title_fullStr | Case Report: Diagnostic and therapeutic challenges in acute myocardial infarction years after aortic replacement surgery: a case of severe vascular tortuosity |
| title_full_unstemmed | Case Report: Diagnostic and therapeutic challenges in acute myocardial infarction years after aortic replacement surgery: a case of severe vascular tortuosity |
| title_short | Case Report: Diagnostic and therapeutic challenges in acute myocardial infarction years after aortic replacement surgery: a case of severe vascular tortuosity |
| title_sort | case report diagnostic and therapeutic challenges in acute myocardial infarction years after aortic replacement surgery a case of severe vascular tortuosity |
| topic | Stanford type A aortic dissection aortic computed tomography angiography coronary artery disease acute myocardial infarction coronary angiography |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2025.1611019/full |
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