A Case of Ascending Aorta Replacement for Chronic Aortic Dissection by Minimally Invasive Cardiac Surgery

Yoshiki Endo	Keita Kikuchi	Kotaro Suzuki
Takayoshi Matsuyama	Dai Une	Yasuhisa Fukada
Atsushi Kurata

（Department of Cardiovascular Surgery, Yamato Seiwa Hospital, Yamato, Japan, and Division of Cardiovascular Surgery＊, Yamagata Prefectural Central Hospital, Yamagata, Japan）

The number of surgical treatments for acute aortic dissection in octogenarians is increasing. They should return to their daily life as soon as possible after the operation without any complications. Some literature reported that minimally invasive cardiac surgery（MICS）helps quick recovery for the patients. We report a case of minimally invasive ascending aorta replacement for Stanford type A chronic thrombosed aortic dissection in an octogenarian to help quick recovery. An 81-year-old man was admitted in our hospital suffering from chest and back pain. Enhanced CT scan showed Stanford type A acute thrombosed aortic dissection. The diameter of ascending aorta was 45mm and the diameter of false lumen was 7mm. Therefore we decided on medical treatment for this patient according to the guideline. After four weeks medical treatment, ascending aorta was dilated to 49mm and the false lumen also expanded to 9mm. He underwent minimally invasive ascending aorta replacement to help quick recovery considering his age. He was discharged 11 days postoperatively without any complications. MICS offers a better cosmetic result, less blood loss, less pain, better respiratory function and quick recovery. Thus, minimally invasive operation for the elderly is also very satisfactory.

 

Jpn. J. Cardiovasc. Surg. 44:266-270（2015）

Keywords：minimally invasive cardiac surgery（MICS）;chronic aortic dissection;ascending aorta replacement;type A acute thrombosed aortic dissection