ABSTRACT
We describe a rare case of an acute aortic type A dissection after previous aortic valve replacement and coronary artery revascularization complicated by a contained rupture and right ventricular wall dissection. Although preoperatively echocardiography and CT scan described a pericardial hematoma, intraoperatively no intrapericardial hematoma was found; instead an extended right ventricular wall dissection caused by a large thrombus formation within the right ventricular muscle layers was demonstrated. After replacement of the ascending aorta and removal of the thrombus as the sole treatment for right ventricular wall dissection, the two dissected layers of the right ventricular wall were contracting synchronously again.
Subject(s)
Aortic Dissection/complications , Aortic Rupture/complications , Heart Ventricles , Ventricular Septal Rupture/etiology , Aortic Dissection/diagnostic imaging , Aortic Rupture/diagnostic imaging , Aortic Valve/surgery , Coronary Artery Bypass/adverse effects , Heart Diseases/etiology , Heart Valve Prosthesis Implantation , Hematoma/etiology , Humans , Male , Medical Records , Middle Aged , Pericardium , Tomography, X-Ray ComputedABSTRACT
We present a 63-year-old patient with aortic valve stenosis, ascending aorta aneurysm, aortic coarctation as well as atherosclerotic, elongated, and stenosed aortic arch. Surgical treatment consisted of a complete ascending aorta replacement with a valved composite graft and complete replacement of the aortic arch including the isthmus, and was performed simultaneously through median sternotomy.
