Residual False Lumen Rupture Possibly Triggered by Chest Compression after Reparative Surgery for Type A Aortic Dissection

Daisuke Arima＊,＊＊

Akihide Umeki＊

Tetsufumi Yamamoto＊

（Department of Cardiac Surgery, Asahi General Hospital＊, Asahi, Japan, and Present address:Department of Cardiovascular Surgery, Tsukuba Memorial Hospital＊＊, Tsukuba, Japan）

Several complications of cardiopulmonary resuscitation have been reported. Herein we reported a rare case of rupture in a false lumen immediately following chest compressions. A 79-year-old woman underwent a graft replacement surgery of acute Stanford type A aortic dissection. On POD 6 she developed cardiopulmonary arrest from suffocation by phlegm. She was immediately resuscitated with chest compressions, although bloody discharge from the left chest drainage tube increased. A rupture was detected by contrast enhanced computed tomography scan in the false lumen of the descending aorta. There was a risk of post-resuscitative encephalopathy;therefore, conservative treatment, such as blood transfusion, hemostatic administration and therapeutic hypothermia, were performed. After rewarming the patient, she recovered consciousness without any neurological abnormalities. We should bear the possibility in mind that chest compression carries the risk of residual false lumen rupture.

 

Jpn. J. Cardiovasc. Surg. 48:73-76（2019）

Keywords：chest compression;acute aortic dissection;rupture in a false lumen