[Type A dissection caused by aortic cannulation during coronary artery bypass grafting; report of a case].
A 71-year-old woman who had severe stenosis in the origin of the left anterior descending coronary artery with large diagonal branch was scheduled for coronary artery bypass grafting (CABG). After harvesting of bypass conduits, aortic cannulation was performed into the ascending aorta. Immediately after insertion of the cannula, however, the ascending aorta changed to a bluish color. Epiaortic ultrasonography revealed aortic dissection. Replacement of the ascending aorta was carried out using circulatory arrest under deep hypothermia. The intimal tear was located at the cannulation site. After this procedure, scheduled CABG the left internal thoracic artery to the left anterior descending coronary artery and the saphenous vein graft to the diagonal branch was performed. The proximal site of the saphenous vein graft was anastomosed to the replaced graft. The postoperative course was uneventful. Rapid identification and appropriate surgical management are necessary to minimize patient morbidity and mortality.
Nakayama
Yoshihiro
Y
Department of Cardiovascular Surgery, Ohsumikanoya Hospital, Kanoya, Japan.
Minematsu
N
N
Koga
K
K
D000368:Aged; D000784:Aortic Dissection / Q000209:etiology / Q000601:surgery*; D001011:Aorta / Q000601:surgery; D001014:Aortic Aneurysm / Q000209:etiology / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D002404:Catheterization / Q000009:adverse effects*; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D023921:Coronary Stenosis / Q000601:surgery; D005260:Female; D006801:Humans; D007431:Intraoperative Complications