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
Summary
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.
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