A Case of Intraoperative Acute Aortic Dissection with Coronary Occlusion during Aortic Valve Replacement.
10.4326/jjcvs.27.314
- VernacularTitle:大動脈弁置換術中に冠状動脈閉塞を伴う急性大動脈解離をきたした１例
- Author:
Hiromitsu Takakura
;
Tatsuumi Sasaki
;
Kazuhiro Hashimoto
;
Takashi Hachiya
;
Katsuhisa Onoguchi
;
Isao Aoki
;
Shigeyuki Takeuchi
;
Tatsuta Arai
- Publication Type:Journal Article
- From:Japanese Journal of Cardiovascular Surgery
1998;27(5):314-317
- CountryJapan
- Language:Japanese
-
Abstract:
A 70-year-old man was found to have aortic regurgitation and underwent aortic valve replacement. About 10 minutes after disconnection from the cardiopulmonary bypass, cardiac arrest occurred suddenly and the bypass was immediately resumed. At this point, a Stanford type A aortic dissection was detected by transesophageal echocardiography, and the orifice of the left coronary artery was considered to be occluded by invasion of a hematoma. Although ascending aortic replacement with a prosthesis was performed under hypothermic circulatory arrest with selective cerebral perfusion, the heart did not resume vigorous beating. Therefore, saphenous vain graftings to the left anterior descending artery and the right coronary artery were performed. Finally, the patient could be weaned from the cardiopulmonary bypass. On postoperative digital subtraction angiography, neither occlusion nor stenosis in both coronary arteries was observed. We conclude that it would be considered to perform coronary artery bypass graftings in this particular condition.
