ABSTRACT
A 74-year-old man undergone mitral valve plasty. After cessation of cardiopulmonary bypass, bleeding persisted from the cardioplegia injection site and dilatation of the ascending aorta with discoloration was observed. The diagnosis of type A aortic dissection extending to the descending aorta was made by transesophageal echocardiogram. Replacement of the ascending aorta was performed under deep hypothermic circulatory arrest. The postoperative course was uneventful. The false lumen of the aortic arch and descending aorta was thrombosed completely on postoperative computed tomography. Intraoperative aortic dissection is a rare but fatal complication of cardiopulmonary bypass. Prompt recognition and appropriate surgical management are of prime importance.
ABSTRACT
Total aortic arch repair was performed simultaneously with the aortic root replacement using Cabrol's method in a 61-year-old man with recurrent aortic dissection. Two months prior to admission the patient had undergone a separate replacement of the aortic valve and ascending aorta for acute type A dissection with aortic regurgitation due to a bicuspid valve. He developed a suture line disruption caused by recurrent dissection in the aortic root which had been reinforced with GRF glue on the first operation. During the second operative procedure the dilated aortic arch with the remnant false lumen was found to be extensively injured. Therefore total arch replacement was required in addition to aortic root reconstruction preserving the previously placed mechanical valve.