title: Lethal thrombus in the carotid artery during operation for acute aortic dissection with cerebral malperfusion.
abstract: A drowsy patient with acute type A aortic dissection and cerebral malperfusion required emergency operation. Because the right carotid artery was totally obstructed, cerebral perfusion was first restored by cannulating it and the left femoral artery before midline sternotomy. However, a long fresh thrombus was found flowing backward from the obstructed carotid artery. This thrombus was removed, and both arteries were connected through a Y-shaped extracorporeal circulation circuit to reperfuse the brain. During the subsequent aortic procedure, both arteries were used for arterial inflow. Such thrombi can cause grave postoperative neurologic dysfunction. Carotid artery cannulation is mandatory in such cases.
authors.affiliation: Department of Cardiovascular Surgery, Saitama Medical School, Iruma-gun, Japan. imanaka@saitama-med.ac.jp
authors.forename: Kazuhito
authors.initials: K
authors.lastname: Imanaka
authors.forename: Motonobu
authors.initials: M
authors.lastname: Nishimura
authors.forename: Ayumu
authors.initials: A
authors.lastname: Masuoka
authors.forename: Masanori
authors.initials: M
authors.lastname: Ogiwara
authors.forename: Masaaki
authors.initials: M
authors.lastname: Kato
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Asano
authors.forename: Shunei
authors.initials: S
authors.lastname: Kyo
mesh_terms: D000208:Acute Disease; D000784:Aortic Dissection / Q000601:surgery*; D001014:Aortic Aneurysm / Q000601:surgery*; D002341:Carotid Artery Thrombosis / Q000209:etiology / Q000601:surgery*; D002561:Cerebrovascular Disorders / Q000209:etiology*; D004630:Emergencies; D006801:Humans; D007431:Intraoperative Complications / Q000601:surgery; D008297:Male; D008875:Middle Aged