title: Successful staged operation for acute aortic dissection and chronic thromboembolic pulmonary hypertension.
abstract: We describe surgical treatment for a patient with chronic thromboembolic pulmonary hypertension who developed acute type A aortic dissection. Acute aortic dissection is a life-threatening disease and must be operated emergently, and chronic thromboembolic pulmonary hypertension can be treated only by pulmonary endarterectomy. We performed a staged procedure consisting of hemiarch replacement with antegrade cerebral perfusion first and pulmonary endareterectomy with periods of deep hypothermic circulatory arrest a week later. We used extracorporeal membrane oxygenation after aortic surgery as a bridge to pulmonary endarterectomy. Our strategy was useful for patients with chronic thromboembolic pulmonary hypertension who require complicated aortic surgery.
authors.affiliation: Department of Cardiovascular Surgery, Chiba University Graduate School of Medicine, Chiba, Japan keiichi-ishida@pro.odn.ne.jp.
authors.forename: Keiichi
authors.initials: K
authors.lastname: Ishida
authors.affiliation: Department of Cardiovascular Surgery, Chiba Medical Center, Chiba, Japan.
authors.forename: Masahisa
authors.initials: M
authors.lastname: Masuda
authors.affiliation: Department of Cardiovascular Surgery, Chiba University Graduate School of Medicine, Chiba, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Ishizaka
authors.affiliation: Department of Cardiovascular Surgery, Chiba University Graduate School of Medicine, Chiba, Japan.
authors.forename: Goro
authors.initials: G
authors.lastname: Matsumiya
mesh_terms: D000368:Aged; D000784:Aortic Dissection / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D001014:Aortic Aneurysm / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D050792:Circulatory Arrest, Deep Hypothermia Induced; D004691:Endarterectomy; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications / Q000601:surgery*; D011655:Pulmonary Embolism / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed
keywords: Aortic dissection; Aortic operation; Pulmonary hypertension