Aortic root replacement in a patient with previous coronary artery bypass

2021 ◽  
pp. 021849232199738
Author(s):  
Juan F Parra ◽  
Eric E Vinck ◽  
Jessica N González ◽  
Hernando Santos
Keyword(s):  
Coronary Artery ◽  
Aortic Dissection ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Type A ◽  
Composite Graft ◽  
Acute Type ◽  
Thoracic Aortic Dissection ◽  
Threatening Condition ◽  
Life Threatening

Acute type A thoracic aortic dissection is a life-threatening condition that requires rapid diagnosis and prompt surgical intervention. Prior cardiac surgery is recognized as a predisposing risk factor. Here, we report a rare case and successful surgical repair of a late presenting acute type A thoracic aortic dissection four years after a three-vessel coronary artery bypass grafting. Resection of the aortic valve and aneurysmal tissue was required, reconstruction was done with a composite graft, and the native coronary ostia and aorto-saphenous buttons were preserved.

scholarly journals Concomitant Coronary Artery Bypass in Patients with Acute Type A Aortic Dissection

2021 ◽  
Author(s):  
Mohammed Morjan ◽  
Diana Reser ◽  
Vedran Savic ◽  
Juri Sromicki ◽  
Francesco Maisano ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Aortic Dissection ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Type A ◽  
Acute Type ◽  
Type A Aortic Dissection

scholarly journals The Impact of CK-MB Elevation in Patients With Acute Type A Aortic Dissection With Coronary Artery Involvement

2021 ◽  
Author(s):  
Naoshi Minamidate ◽  
Tomoaki Suzuki
Keyword(s):  
Coronary Artery ◽  
Aortic Dissection ◽  
Statistical Significance ◽  
Artery Bypass ◽  
Type A ◽  
Coronary Perfusion ◽  
Acute Type ◽  
Type A Aortic Dissection ◽  
Coronary Artery Involvement ◽  
The Impact

Abstract Background Acute coronary artery involvement (ACI) is a lethal complication of acute type A aortic dissection. Although ACI has been reported as one of the prognostic factors of acute type A aortic dissection, it does not always cause coronary ischemia. The extent of myocardial damage varies from case to case. Moreover, since the definition of ACI varies from paper to paper, it is unknown what the difference is between ACI with and without myocardial necrosis. In general, it can be assumed that cases with myocardial infarction have worse results. However, it is unknown how poor ACI is with myocardiac ischemia and how optimistic it is without it. This study compared the surgical results between the two groups of ACI with or without myocardiac ischemia. Methods Among 348 patients who underwent an emergency operation for acute type A aortic dissection, there were 28 (8.0%) patients complicated by ACI and underwent additional coronary artery bypass grafting. We divided 26 of those patients into two groups; the MI group ( with CK-MB elevation) and the NMI group (without CK-MB elevation) and compared both groups. Results Of the 26, sixteen were in the MI group, and ten were in the NMI group. The average CK-MB in the MI group was 225.5 IU/L, and that in the NMI group was 13.5 IU/L. The mean time from onset to surgery was 248 minutes in the MI group, 250 minutes in the NMI group. There was statistical significance in mortality ( 69% vs. 13%, p=0.03). There was no significance in major complications (ICU days, reintubation, reoperation, pneumonia, sepsis). Conclusions Acute coronary artery involvement was associated with 8.0% of patients with ATAAD, and 62% of them had myocardial ischemia with CK-MB elevation. As expected, the MI group had significantly higher mortality than the NMI group. It is crucial for cases with suspected ACI to obtain coronary perfusion as soon as possible to prevent CK-MB from elevationg.

Acute Type-A Aortic Dissection with Obstruction of the Right Coronary Artery

2014 ◽  
Vol 17 (4) ◽  
pp. 196
Author(s):  
Erhan Kaya ◽  
Halit Yerebakan ◽  
Daniel Spielman ◽  
Omer Isik ◽  
Cevat Yakut
Keyword(s):  
Coronary Artery ◽  
Aortic Dissection ◽  
Right Coronary Artery ◽  
Type A ◽  
Sudden Onset ◽  
Acute Type ◽  
Type A Aortic Dissection ◽  
Coronary Syndrome ◽  
Bentall Procedure ◽  
The Right

Occlusion of a coronary artery by an acute type A aortic dissection presents a life-threatening emergency that is rarely seen and easy to misdiagnose. We present the case of a 75-year-old male who experienced sudden onset of severe left-sided chest pain due to an acute type A aortic dissection that obstructed the right coronary artery. Following an initial misdiagnosis of acute coronary syndrome, imaging revealed the presence of an aortic dissection. An emergency modified Bentall procedure was performed, in which the damaged aorta and aortic valve were replaced.

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