A Report of Successful Treatment of an Acute Aortic Dissection Associated with a Long-Term Steroid Therapy for Hypopituitarism

(Department of Cardiovascular Surgery, Kawachi General Hospital, Higashi-Osaka, Japan)

Masao Tayama Nobuo Sakagoshi Harumasa Yasuda
A 58-year-old man was admitted with a diagnosis of an acute Stanford type A aortic dissection after 20-year-long steroid therapy for hypopituitarism. The graft replacement of the ascending aorta was performed as an emergency procedure under deep hypothermic selective cerebral perfusion. We administered 1,000 mg of methylprednisolone during cardiopulmonary bypass, injected 500 mg/day of hydrocortisone during postoperative day 1 to 4, and then administered orally 40 mg/day of hydrocortisone. Then 200g of levothyroxine sodium was given orally from postoperative day 6. There are some reports about acute aortic dissection associated with long-term steroid therapy in SLE or aortitis syndrome, but reports involving hypopituitarism are very rare.
@Jpn. J. Cardiovasc. Surg. 32F158 -160 (2003)