Early acute aortic dissection of the donor aorta after orthotopic heart transplantation.
Acute type A aortic dissection is an uncommon complication after orthotopic heart transplantation and usually affects the native aorta. Seven cases reported in the literature describe an aortic dissection confined to the donor aorta and only in two of them were they detected during the early postoperative period. We describe the case of a 58-year-old man, the recipient of a cardiac allograft for ischemic cardiomyopathy 20 days earlier, who presented an acute type A aortic dissection limited to the donor aorta. Transesophageal echocardiography revealed severe aortic regurgitation and an intimal tear 2 cm above commissures. The patient was successfully treated with a composite valve graft. This case is the first successful repair in a cardiac allograft with acute aortic dissection of the donor aorta during the early postoperative period using a Bentall procedure.
Lopez
Carlos Esteban Martin
CE
Department of Cardiac Surgery, University Hospital 12 de Octubre, Madrid, Spain. carlosestebanmartin@hotmail.com
Lopez
Maria Jesus
MJ
de Diego
Javier
J
Cortina
Jose Maria
JM
D000208:Acute Disease; D000784:Aortic Dissection / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D001011:Aorta / Q000000981:diagnostic imaging / Q000637:transplantation*; D001014:Aortic Aneurysm / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D001022:Aortic Valve Insufficiency / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D009202:Cardiomyopathies / Q000601:surgery; D002315:Cardiopulmonary Bypass; D017548:Echocardiography, Transesophageal; D016027:Heart Transplantation / Q000009:adverse effects*; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D012720:Severity of Illness Index; D013997:Time Factors; D014184:Transplantation, Homologous; D016896:Treatment Outcome