Two Successful Proximal Reoperation Cases after Acute Type A Dissection Repair
10.4326/jjcvs.39.355
- VernacularTitle:急性 A 型解離に対する上行・弓部置換後遠隔期の大動脈基部拡大に対する再手術2例の経験
- Author:
Tomohiko Sakamoto
;
Yasushi Tsutsumi
;
Osamu Monta
;
Keitaro Koshi
;
Yousuke Takahashi
;
Kimitoshi Kitani
;
Hirokazu Ohashi
- Publication Type:Journal Article
- Keywords:
acute aortic dissection;
aortic root aneurysm;
proximal re-operations
- From:Japanese Journal of Cardiovascular Surgery
2010;39(6):355-358
- CountryJapan
- Language:Japanese
-
Abstract:
We report 2 cases of successful proximal reoperations after acute type A dissection. Case 1 : A 53-year-old man underwent ascending aorta and aortic arch replacement and aortic valve re-suspension for acute type A dissection with aortic valve regurgitation in 1992. Thirteen years after the first operation, computed tomography demonstrated a Valsalva aneurysm (74 mm) and Doppler echocardiography showed moderate aortic valve regurgitation. Therefore, we performed an operation. We could not locate the dissection in the Valsalva sinus, and the aortic valve cusps had organic change. A David procedure was performed. The postoperative course was uneventful and he was discharged on the 19th postoperative day. Case 2 : A 65-year-old woman underwent ascending aorta replacement and aortic valve resuspension for acute type A dissection with aortic valve regurgitation in 1997, but 11 years after the first operation, computed tomography demonstrated a Valsalva aneurysm (55 mm) and arch aneurysm (65 mm) with stenosis of the innominate vein and she had facial and left arm edema. Doppler echocardiography showed moderate aortic valve regurgitation. We could not find the location of dissection in the Valsalva sinus or aortic arch, and aortic valve cusps had no organic change. A Bentall procedure and total arch replacement were performed and her postoperative course was uneventful.
