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Atherosclerotic disruption of the aortic arch during coronary artery bypass operation
F S Eckstein1, H P Dinkel, A Exadactylos
1Clinic for Cardiovascular Surgery and Diagnostic Radiology, University Hospital of Berne (Inselspital), CH-3010, Berne, Switzerland.
Insights
A 70-year-old man with severe coronary artery disease experienced aortic rupture during surgery. The aortic arch was successfully repaired using the elephant trunk technique, followed by coronary artery bypass grafting.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Vascular Surgery
Background:
- A 70-year-old male patient presented with symptomatic three-vessel coronary artery disease requiring myocardial revascularization.
- The patient underwent extracorporeal circulation for the planned surgical procedure.
Observation:
- Intrathoracic bleeding occurred during extracorporeal circulation, raising suspicion of aortic rupture.
- An iatrogenic plaque rupture in the aortic arch concavity was identified, attributed to cannulation attempts.
Findings:
- The aortic arch was successfully repaired using the elephant trunk technique.
- Coronary artery bypass grafts were subsequently anastomosed to the stenosed coronary arteries.
Implications:
- This case highlights a rare complication during cardiac surgery and its successful management.
- The elephant trunk technique proved effective for repairing iatrogenic aortic arch rupture in this context.
- Successful surgical intervention led to the patient's recovery and discharge within two weeks.
Abstract:
A 70-year-old-man presented with a symptomatic three vessel coronary artery disease and was scheduled for myocardial revascularization. During extracorporeal circulation an intrathoracal bleeding occurred and aortic rupture was suspected. An iatrogenic plaque rupture in the concavity of the aortic arch was found due to cannulation attempts. The aortic arch was grafted in the so-called elephant trunk technique. Thereafter bypass grafts were anastomosed to the stenosed coronary arteries. The patient was discharged from hospital after 2 weeks in good condition.