[Aortic root and arch replacement late after ascending aortic replacement for acute aortic dissection; report of a case].
Surgical treatment for acute type A aortic dissection remains controversial, especially when the aortic dissection extends to the aortic root and arch. A 73-year-old woman presented with palpitation. She had previously undergone ascending aorta replacement for acute type A aortic dissection with reinforcement of the proximal and distal aortic stumps using gelatin-resorcinol-formaldehyde (GRF) glue, conducted by a different surgical team 7 years ago. Echocardiography and computed tomography revealed dilatation of both ends of the reconstructed aorta, with aortic valve insufficiency. Hence, we performed Bentall procedure, partial aortic arch replacement, and coronary artery bypass grafting. The postsurgical course was uneventful. Redo operations may be avoidable, if, in the initial operation for acute type A aortic dissection with dissected aortic root and arch, surgery is performed without use of GRF glue for reinforcement of stumps. We recommend to perform the Bentall procedure, partial remodeling procedure, or valve-sparing aortic root replacement for reconstruction of the aortic root and arch replacement for repair of the aortic arch.
Department of Cardiovascular Surgery, Hokuto Hospital, Obihiro, Japan.
Hiroyuki
H
Suzuki
Toshihiro
T
Fujimatsu
Hiromitsu
H
Teratani
Takanori
T
Ogawa
Tomonari
T
Akatsu
Kazuhiro
K
Takahashi
D000208:Acute Disease; D000368:Aged; D001011:Aorta / Q000601:surgery*; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging / Q000601:surgery*; D001018:Aortic Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D014057:Tomography, X-Ray Computed