Acute type A aortic dissection complicated with acute inferior myocardial infarction following aortic valve replacement.
Acute aortic dissection complicated with acute myocardial infarction (AMI) is the most fatal situation. We experienced the successful treatment for acute type A aortic dissection complicated with inferior AMI following aortic valve replacement (AVR). A 60-year-old man had had AVR for aortic regurgitation. Sixteen months after the AVR, he had a sudden onset of severe chest pain with complete atrioventricular block. Immediately, temporary pacing and cardiac catheterization were conducted, showing the occlusion of the right coronary artery due to acute type A aortic dissection. On his way to our hospital, direct current shock was conducted 3 times for ventricular fibrillation. We replaced the ascending aorta combined with coronary artery bypass grafting and the postoperative course was uneventful. The key to treat acute aortic dissection complicated with AMI is early accurate diagnosis, prompt temporary pacing for bradycardia, defibrillation for lethal arrhythmia and insertion of a perfusion catheter if possible. These preoperative hemodynamic stabilization gives us the chance to save these patients.
Kamada
Makoto
M
Department of Cardiovascular Surgery, Iwate Prefectural Central Hospital, Morioka, Iwate, Japan.
Ohsaka
Kenji
K
Nagamine
Susumu
S
Kakihata
Hidemitsu
H
D000784:Aortic Dissection / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D001014:Aortic Aneurysm / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D001021:Aortic Valve / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D006348:Cardiac Surgical Procedures; D006324:Heart Arrest, Induced; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications*; D014057:Tomography, X-Ray Computed