A Patient with an Aortic-Root Pseudoaneurysm in Whom Intraaortic Balloon Pumping Improved Cardiogenic Shocka

(Cardiovascular Center and Emergency Center*, Yokohama City University Medical Center, Yokohama, Japan and The First Department of Surgery, Yokohama City University**, Yokohama, Japan)

Hiroyuki Adachi Kiyotaka Imoto Shinichi Suzuki
Keiji Uchida Motohiko Gouda Toshiki Hatsune
Makoto Okiyama Takayuki Kosuge* Hiroshi Toyoda*
Yoshinori Takanashi**
A 76-year-old woman with Stanford type A acute aortic dissection underwent replacement of the ascending aorta with the use of gelatin-resorcin-formalin glue. The patient suffered sudden cardiogenic shock at home 15 months after surgery and was admitted to the Emergency Center of our hospital. A series of examinations revealed an aortic-root pseudoaneurysm associated with anastomotic disruption. Cardiogenic shock caused by obstruction of the ascending aortic graft due to anastomotic disruption was diagnosed. An intraaortic balloon pump (IABP) was inserted, and the patient's circulatory status improved. On the following day, reanastomosis of the aortic root graft was performed. On day 32 after surgery, the patient was discharged from the hospital in good condition. IABP can stabilize circulatory status and improve cardiogenic shock in the short term in patients with an aortic-root pseudoaneurysm caused by narrowing of the graft lumen, as in the present patient. IABP may thus be a useful ancillary measure before radical operation.
@Jpn. J. Cardiovasc. Surg. 35: 367-370 (2006)