Acute Type A Aortic Dissection Complicated with Acute Myocardial Infarction in a Case with an Aberrant Right Coronary Artery
10.4326/jjcvs.37.234
- VernacularTitle:右冠動脈起始異常に発症した Stanford A 型急性大動脈解離，急性心筋梗塞に対する1手術例
- Author:
Koji Yamana
;
Masaru Sawazaki
;
Shiro Tomari
;
Akihiko Usui
;
Yuichi Ueda
- Publication Type:Journal Article
- From:Japanese Journal of Cardiovascular Surgery
2008;37(4):234-236
- CountryJapan
- Language:Japanese
-
Abstract:
Acute aortic dissection complicated with acute myocardial infarction in a case of 61-year-old woman with an aberrant right coronary artery was successfully treated by emergency operation fore type A acute aortic dissection. However, cardiogenic shock and bradycardia occurred after induction of anesthesia due to right ventricle myocardial ischemia. Cardiopulmonary bypass was established quickly and deep hypothermia was induced. We also perfused the right coronary artery with an external shunt tube to prevent the progression of the right ventricular infarction. The right coronary artery, which originated above the left coronary sinus, was dissected totally. We performed ascending and aortic arch replacement and coronary artery bypass grafting with a saphenous vein graft to the right coronary artery under hypothermic circulatory arrest. She had no major reduction of cardiac function. Although it was a rare combination, aberrant right coronary artery was vulnerable to myocardial ischemia associated with acute type A dissection. The external coronary shunt tube was useful for this type of myocardial ischemia.
