Asymptomatic Stanford Type A Aortic Dissection Developing after Off-Pump Coronary Artery Bypass Grafting with Right-Sided Aortic Arch

Shunsuke Sakamoto＊

Takuya Komada＊＊

Koji Onoda＊

（Department of Cardiovascular Surgery, Shingu Municipal Medical Center＊, Shingu, Japan, and Department of Thoracic Surgery, Matsusaka Central General Hospital＊＊, Matsusaka, Japan）

A 69-year-old man with type II right-sided aortic arch（RAA）underwent an off-pump coronary artery bypass grafting（OPCAB）in December, 2017. He underwent an abdominal aortic aneurysm resection and graft replacement in April, 2018. The postoperative computed tomography（CT）that was performed in May 2018 revealed aortic dissection from the ascending aorta to the aortic arch, although he was asymptomatic. We evaluated the native coronary artery and patent bypass grafts by coronary CT. Graft replacement of the ascending aorta and partial aortic arch was carried out on an elective basis and the proximal anastomotic site of the vein grafts was attached to the prosthetic graft. Stanford type A aortic dissection（AAD）after previous coronary artery bypass grafting differs from spontaneous AAD in presentation, management and outcome. We report here a successful surgical case with RAA and AAD after OPCAB.

 

Jpn. J. Cardiovasc. Surg. 48:267-271（2019）

Keywords：coronary artery bypass grafting;Stanford type A aortic dissection;right-sided aortic arch