A Case of AS (Bicuspid Aortic Valve) and Aneurysm of Ascending Aorta Complicated with Intraoperative Aortic Dissection

(Department of Thoracic Surgery, Ome Municipal General Hospital, Tokyo, Japan and Thoracic Cardiovascular Surgery Department, Tokyo Medical and Dental University*, Tokyo, Japan)

Naoto Miyagi Nagahisa Oshima Toshizumi Shirai
Makoto Sunamori*
A 73-year-old woman was due to undergo elective AVR and aortoplasty because of aortic stenosis (AS) and an ascending aortic aneurysm. During the operation, after the start of cardiopulmonary bypass, the ascending aorta was found to be dilated and discolored. A diagnosis of type A dissection was made by transesophageal echocardiography. Replacement of the ascending aorta and AVR were performed under deep hypothermic circulatory arrest. After the operation, VTR revealed that the ascending aorta was dissected from the cardioplegia injection site. The postoperative course was good and she was discharged on postoperative day 28. Intraoperative aortic dissection is a rare but lethal complication, so it is important to recognize it rapidly and manage it appropriately.
@Jpn. J. Cardiovasc. Surg. 35: 41-44 (2006)