A Case of Intraoperative Acute Aortic Dissection during Mitral Valve Plasty

(Second Department of Surgery, Faculty of Medicine, Kagoshima University, Kagoshima, Japan)

Masahiro Ueno Yukinori Moriyama Yoshifumi Iguro
Koichi Hisatomi Riichiro Toda Hitoshi Matsumoto
Akira Kobayashi Goichi Yotsumoto Yoshihiro Fukumoto
Akira Taira
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.
@Jpn. J. Cardiovasc. Surg. 29: 29-32 (2000)