A Case of Preoperative DIC and Carotid Artery Occlusion due to Type A Acute Aortic Dissection

Rei HATAYAMA; Aya SAITO; Keiji UCHIDA; Shota YASUDA; Tomoki CHO; Ryo IZUBUCHI; Shotaro KANEKO; Atsushi MATSUMOTO; Makoto IKEMATSU; Sho KAKUTA

Return

A Case of Preoperative DIC and Carotid Artery Occlusion due to Type A Acute Aortic Dissection

VernacularTitle:術前にDICと右総頸動脈閉塞を合併したA型急性大動脈解離の1例
Author: Rei HATAYAMA ¹ ; Aya SAITO ² ; Keiji UCHIDA ¹ ; Shota YASUDA ¹ ; Tomoki CHO ¹ ; Ryo IZUBUCHI ¹ ; Shotaro KANEKO ¹ ; Atsushi MATSUMOTO ¹ ; Makoto IKEMATSU ¹ ; Sho KAKUTA ¹
Author Information

1. Cardiovascular Center, Yokohama City University Medical Center
2. Department of Surgery, Yokohama City University Hospital
Keywords: type A acute aortic dissection; DIC; right common carotid occlusion
From:Japanese Journal of Cardiovascular Surgery 2024;53(5):278-282
CountryJapan
Language:Japanese
Abstract: A 61-year-old male presented to another hospital with sudden chest and back pain, and CT revealed a diagnosis of type A acute aortic dissection with patent false lumen. The ascending aortic diameter was 45 mm and the right common carotid artery was occluded. There were no neurological abnormalities, no pericardial effusion, and only mild AR. Eight hours after onset, the patient was transferred to our hospital. The laboratory data showed severe DIC with fibrinogen <50 mg/dl, so that medical DIC treatment was given first because of the high risk of bleeding. Twenty-two hours after the onset, DIC improved and surgery was initiated. The right common carotid artery was ligated for fear of thrombus dispersion at the periphery of the occlusion site. An ascending arch replacement was then performed. Postoperative hemostasis was good, and no new neurological abnormalities were observed. Usually, type A acute aortic dissection is indicated for emergency surgery, but in this case, DIC treatment took precedence. We report here a rare experience.