The patient underwent coronary angiography and bilateral carotid angiography due to history of cerebrovascular accident and aortography due to possibility of aortic dissection.
Neither aortography nor pulmonary artery angiography showed other coronary artery anomalies leading to a diagnosis of agenesis of LCX with superdominant right coronary artery (RCA).
Over a 0.035-inch diameter guidewire (Terumo, Osaka, Japan), an abdominal aortography was obtained with a 5F Cobra catheter (Cordis, Johnson & Johnson, Miami, USA) by injecting a 8-10 ml contrast media, which shows the main or accessory renal arteries on either side.
CoA was defined as the presence of systemic hypertension with an upper to lower-limb systolic blood pressure (BP) difference >20 mm Hg, which was confirmed by echocardiography, computed tomography (CT) angiography or aortography. Patients with long segmental coarctation, hypoplasia of aortic arch, patients under 10 years of age or those with a body weights <30 kg were excluded from the study.
A 46-year-old male patient was diagnosed as acute Type A aortic dissection with normal aortic valve by computed tomography aortography (CTA) and transthoracic echocardiography.
Via right femoral artery access, biplane digital subtraction abdominal aortography was performed, demonstrating a 4.7x3.5x2.9 cm pseudoaneurysm originating from the posterior wall of the infrarenal abdominal aorta (Fig.
Mason Sones, Jr., a pediatric cardiologist at the Cleveland Clinic, inadvertently power injected 20 mL of hypaque via an NIH catheter into the right coronary artery, as a result of catheter whiplash into the ostium of the vessel during root aortography. To everyone's surprise, the patient, a 26-year-old man with rheumatic aortic and mitral valve disease, survived the procedure.
Digital subtraction angiography (DSA) and invasive aortography are reserved for cases in which the diagnosis of acute aortitis cannot be excluded by noninvasive methods or to confirm the diagnosis.
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