title: [Aortic root rupture during an operation in a patient with acute aortic dissection].
abstract: A 73-year-old woman with acute aortic dissection (DeBakey type II) and cardiac tamponade was transferred to our emergency unit. She had a temporary blackout during transfer. An emergency operation was performed. We started core cooling with the superior vena cava, inferior vena cava, and transapical aortic cannulation. When the bladder temperature was 30.5 degrees C, esophageal temperature was 28.7 degrees C, and rectal temperature was 30.5 degrees C, the aortic root suddenly ruptured. We changed the arterial cannulation sites from the apex to the dissecting ascending aorta, and the ascending aorta was cross-clamped. However, the patient's pupils became dilated. Therefore, we started selective cerebral perfusion to avoid prolonged cerebral malperfusion. This procedure took approximately 30 minutes, from the aortic root rupture to selective perfusion. We performed both aortic root and ascending aortic replacement. After the operation, the patient had no neurological or other organ complications and she was discharged 11 days after surgery.
authors.affiliation: Division of Cardiovascular Surgery, Jichi Medical University, Shimotsuke, Japan.
authors.forename: Soki
authors.initials: S
authors.lastname: Kurumisawa
authors.forename: Arata
authors.initials: A
authors.lastname: Muraoka
authors.forename: Kei
authors.initials: K
authors.lastname: Aizawa
authors.forename: Yasuhito
authors.initials: Y
authors.lastname: Sakano
authors.forename: Yuichirou
authors.initials: Y
authors.lastname: Kaminishi
authors.forename: Shinichi
authors.initials: S
authors.lastname: Ohki
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Saito
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Konishi
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Misawa
mesh_terms: D000208:Acute Disease; D000368:Aged; D000784:Aortic Dissection / Q000601:surgery*; D001019:Aortic Rupture / Q000209:etiology*; D005260:Female; D006801:Humans; D007431:Intraoperative Complications