Imaging Features of Complications after Coronary Interventions and Surgical Procedures.
Harold GoerneDiego de la FuenteMiguel CabreraAbhishek ChaturvediDaniel VargasPhillip M YoungSachin S SabooPrabhakar Shantha RajiahPublished in: Radiographics : a review publication of the Radiological Society of North America, Inc (2021)
Coronary artery interventions and surgical procedures are used in the treatment of coronary artery disease and some congenital heart diseases. Cardiac and noncardiac complications can occur at variable times after these procedures, with the clinical presentation ranging from asymptomatic to devastating symptoms. Invasive coronary angiography is the reference standard modality used in the evaluation of coronary arteries, with intravascular US and optical coherence tomography providing high-resolution information regarding the vessel wall. CT is the mostly commonly used noninvasive imaging modality in the evaluation of coronary artery intervention complications and allows assessment of the stent, lumen of the stent, lumen of the coronary arteries, and extracoronary structures. MRI is limited to the evaluation of the proximal coronary arteries but allows comprehensive evaluation of the myocardium, including ischemia and infarction. The authors review the clinical symptoms and pathophysiologic and imaging features of various complications of coronary artery interventions and surgical procedures. Complications of percutaneous coronary interventions are discussed, including restenosis, thrombosis, dissection of coronary arteries or the aorta, coronary wall rupture or perforation, stent deployment failure, stent fracture, stent infection, stent migration or embolism, and reperfusion injury. Complications of several surgical procedures are reviewed, including coronary artery bypass grafting, coronary artery reimplantation procedure (for anomalous origin from opposite sinuses or the pulmonary artery or as part of surgical procedures such as arterial switching surgery and the Bentall and Cabrol procedures), coronary artery unroofing, and the Takeuchi procedure. Online supplemental material is available for this article. ©RSNA, 2021.
Keyphrases
- coronary artery
- pulmonary artery
- high resolution
- coronary artery disease
- coronary artery bypass grafting
- risk factors
- minimally invasive
- physical activity
- optical coherence tomography
- randomized controlled trial
- left ventricular
- percutaneous coronary intervention
- computed tomography
- healthcare
- cardiovascular disease
- type diabetes
- acute myocardial infarction
- acute coronary syndrome
- pulmonary hypertension
- blood flow
- subarachnoid hemorrhage
- heart failure
- cerebral ischemia
- pulmonary embolism
- magnetic resonance
- social media
- fluorescence imaging
- aortic valve
- coronary artery bypass
- high speed
- diffusion weighted imaging
- positron emission tomography