Acute Type A Aortic Dissection with Left Main Coronary Malperfusion

Takeo Nakai＊	Kentaro Honda＊	Mitsuru Yuzaki＊
Masahiro Kaneko＊	Hideki Kunimoto＊	Mitsugi Nagashima＊
Yoshiharu Nishimura＊

（Department of Thoracic and Cardiovascular Surgery, Wakayama Medical University＊, Wakayama, Japan）

A 77-year-old woman was admitted to our hospital with a decreased level of consciousness and left hemiplegia. Contrast-enhanced CT showed acute type A aortic dissection and right common carotid artery occlusion. Electrocardiogram findings showed ST segment elevation in the anterolateral wall. The results suggested that the aortic dissection had extended to the left main trunk and caused acute myocardial infarction. Percutaneous coronary intervention（PCI）was performed preoperatively to improve myocardial ischemia reperfusion. After a successful PCI, the patient underwent ascending aorta replacement immediately. In cases of acute aortic dissection involving the left main artery, preoperative PCI prevents extensive myocardial damage and serves as a bridge to surgery.

 

Jpn. J. Cardiovasc. Surg. 48:356-360（2019）

Keywords：type A acute aortic dissection;malperfusion;left main coronary artery