A Surgical Case Report of Three-Channeled Aortic Dissection of the Ascending Aorta / 日本心臓血管外科学会雑誌

ABSTRACT

Three-channeled aortic dissection of the ascending aorta is rare. A 38-year-old man was given a diagnosis of DeBakey type I aortic dissection with three-channel at the ascending aorta on a chest CT scan. Right axillar and left femoral artery and two-stage right atrial cannulas were used to institute cardiopulmonary bypass. Hemiarch replacement was performed. The open proximal anastomosis technique was used under deep hypothermic circulatory arrest and selective cerebral perfusion. This three-channeled aortic dissection was thought to be produced by DeBakey type II dissection first followed by a retrograde dissection of DeBakey type III b. Since obstruction of the brachiocephalic artery due to the expansion of the pseudolumen was found during rewarming, reconstruction of the brachiocephalic artery was necessary. The present case was treated successfully by right axillary artery perfusion and subsequent reconstruction of the brachiocephalic artery.