A Case of Acute Type A Aortic Dissection with Malperfusion of the LMT with a History of Open-Heart Surgery
- VernacularTitle:LMT解離を伴ったStanford A型急性大動脈解離の1救命例
- Author:
Hiroe OTANI
1
;
Hiroyuki WATANABE
1
;
Masayoshi OTSU
1
;
Takuto MARUYAMA
1
Author Information
- Keywords: left main coronary trunk; acute aortic dissection
- From:Japanese Journal of Cardiovascular Surgery 2024;53(3):123-126
- CountryJapan
- Language:Japanese
- Abstract: A 75-year-old woman was referred to our hospital with sudden onset of chest and back pain. She showed ventricular fibrillation during transportation and shock vitals on arrival at the hospital. An electrocardiogram (ECG) showed ST segment elevation in aVR, and emergency coronary angiography (CAG) was performed. CAG revealed malperfusion of the left main coronary artery (LMT) due to type A aortic dissection. Emergency percutaneous coronary intervention (PCI) was performed and coronary revascularization was achieved. Strict blood pressure management was performed in the intensive care unit. She underwent ascending aortic replacement two days after onset of the disease. Although she required long-term postoperative ventilator management, she did not develop low output syndrome (LOS). In this case, emergency PCI minimized myocardial ischemia, and LOS could have been avoided by waiting for circulation to recover and then performing surgery.
