title: Case of sudden death from retrograde type A dissection two days after surgery for a type B dissecting aneurysm.
abstract: A 64-year-old man underwent a descending aortic replacement for a chronic type B dissecting aneurysm with left thoracotomy. The patient was weaned from the mechanical ventilator immediately after surgery without any neurological complications. However, on the second post-operative day, he suddenly suffered from cardiopulmonary arrest when talking with his family. Despite 6 hours of cardiopulmonary resuscitation, the patient died. The postmortem examination revealed a 1000 mL blood volume and huge hematoma in the pericardium owing to a retrograde type A dissection, which descended from an intimal laceration between the common carotid and left subclavian arteries that corresponded with aortic cross clamping. We here report a rare case of iatrogenic retrograde type A dissection caused by surgical clamping on the aortic arch 2 days post-surgery.
authors.affiliation: Department of Cardiovascular Surgery, Surugadai Nihon University Hospital, Tokyo, Japan.
authors.forename: Mitsumasa
authors.initials: M
authors.lastname: Hata
authors.forename: Kenji
authors.initials: K
authors.lastname: Akiyama
authors.forename: Yukihiko
authors.initials: Y
authors.lastname: Orime
authors.forename: Shinji
authors.initials: S
authors.lastname: Wakui
authors.forename: Motomi
authors.initials: M
authors.lastname: Shiono
mesh_terms: D000784:Aortic Dissection / Q000175:diagnosis / Q000601:surgery*; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000175:diagnosis / Q000601:surgery*; D001027:Aortography / Q000379:methods; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects*; D002423:Cause of Death; D002908:Chronic Disease; D003250:Constriction; D003645:Death, Sudden / Q000209:etiology*; D017809:Fatal Outcome; D006801:Humans; D007049:Iatrogenic Disease; D008297:Male; D008875:Middle Aged; D013908:Thoracotomy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D057772:Vascular System Injuries / Q000175:diagnosis / Q000209:etiology*