Two Cases of Stanford A Acute Dissecting Aortic Aneurysm with Right Coronary Occlusion / 日本心臓血管外科学会雑誌

ABSTRACT

Patient 1 was a 62-year-old woman who had been treated for hypertension for three years. Stanford A type acute aortic dissection occurred accompanied by right coronary ischemia. CABG and graft replacement of the ascending aorta were performed 8 hours after the onset of coronary ischemia, but after cardiopulmonary bypass the patient could not be weaned from the RVAD because of right ventricular infarction. On the 8th day after operation, she died due to right heart failure. Patient 2 was a 72-year-old male. Stanford A acute aortic dissection occurred and right coronary ischemia appeared during UCG examination in the ICU. CABG and graft replacement of the ascending aorta and the aortic arch were carried out less than 1 hour from the onset of coronary ischemia. The postoperative course was satisfactory and uncomplicated. If the dissection extends to the aortic root, it is important to monitor the ECG carefully to detect myocardial ischemic changes. In cases with coronary ischemia, early operation and CABG are mandatory.