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Rowland O. Okumu, David O'Donnell, Charles J. McCreery, David Luke, Jonathan D. Dodd, Cabrol shunt for iatrogenic aortic dissection: evaluation with cardiac 64-slice CT, European Heart Journal, Volume 29, Issue 5, March 2008, Page 617, https://doi.org/10.1093/eurheartj/ehm437
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Extract
A 63-year-old man was admitted with intractable angina and underwent elective coronary angiography. He had a history of percutaneous coronary intervention to the left circumflex artery five years previously. Coronary angiography revealed 90% stenosis of the proximal right coronary artery (RCA) (Panel A) and a 3 mm Cypher stent was placed across the lesion. The procedure was complicated by a RCA dissection with retrograde extension to the ostium and subsequently into the ascending aortic wall (Panel B). The patient was referred for urgent surgical repair. Extensive bleeding was encountered at surgery, and the false lumen of the aortic dissection was decompressed with a Cabrol shunt, whereby a dacron graft was intereposed between the lower part of the false lumen and the right atrium.
Six weeks later a 64-slice cardiac CT was performed to non-invasively evaluate patency of the graft. It confirmed a persistent aortic dissection and a patent false lumen (Panel C). It also clearly depicted a widely patent Cabrol shunt, both at the proximal anastomoses with the false lumen and the distal anastomoses with the right atrium (Panel D). A multiphasic reconstruction cine loop throughout the cardiac cycle demonstrated a contrast shunt into the right atrium during ventricular systole (Supplementary data). The patient remains well at 6-month clinical follow-up.
