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Direct Re-implantation of Left Coronary Artery into the Aorta in Adults with Anomalous Origin of Left Coronary Artery from the Pulmonary Artery ALCAPA
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Partial aortic root remodeling for chronic aortic dissection with coronary intimal tear

Shintaro Takago1, Kenji Iino2, Naoki Saito2

  • 1Department of Cardiovascular Surgery, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan. shintaro-takago@live.jp.

General Thoracic and Cardiovascular Surgery
|October 30, 2020
PubMed

Insights

Partial aortic root remodeling effectively treated a chronic aortic dissection in a patient with coronary artery involvement. However, its use without addressing the primary entry point requires careful consideration and close monitoring.

Area of Science:

  • Cardiovascular Surgery
  • Aortic Diseases
  • Interventional Cardiology

Background:

  • Chronic aortic dissection, particularly involving the coronary arteries, presents unique surgical challenges.
  • Partial aortic root remodeling is less commonly reported for chronic aortic dissection compared to other aortic pathologies.

Observation:

  • A 69-year-old male with a history of percutaneous coronary intervention was incidentally diagnosed with chronic type A aortic dissection and an aneurysmal aortic root.
  • Computed tomography revealed the dissection's false lumen originating from the left anterior descending artery and extending to the non-coronary Valsalva sinus.

Findings:

  • The patient underwent successful partial aortic root remodeling, involving resection of the dissected non-coronary Valsalva sinus.
  • The postoperative recovery was uneventful, indicating the procedure's immediate efficacy in this case.

Implications:

  • Partial aortic root remodeling can be an effective treatment for chronic aortic dissection with aneurysmal root, even with coronary artery origins.
  • The controversial aspect lies in not resecting the primary entry tear from the left anterior descending artery, necessitating vigilant long-term patient surveillance.

Keywords:
Chronic aortic dissectionCoronary artery dissectionPartial aortic root remodeling

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