Related Experiment Video
Updated: Sep 5, 2025
06:26
Novel and Innovative Hybrid Technique for Type A Aortic Dissection
Published on: March 28, 2025
463
Type A aortic dissection following heart transplantation: A case report
Zhu Zeng1, Lin-Jie Yang2, Chao Zhang1
1Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, China.
World Journal of Clinical Cases
|July 8, 2022
Summary
A rare case of type A aortic dissection in a heart transplant recipient with an aberrant right subclavian artery required complex hybrid repair. This highlights the challenges in managing aortic complications post-cardiac transplantation.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Transplantation Surgery
Background:
- Cardiac transplantation is the standard for end-stage heart failure, with ~100 procedures annually at the authors' center.
- Common complications include rejection, infection, and dysfunction; aortic dissection is a rare but serious event.
- Management of aortic dissection post-cardiac transplant often necessitates complex hybrid procedures.
Observation:
- A 58-year-old female, post-heart transplant, presented with type A aortic dissection and an aberrant right subclavian artery.
- Initial management included blood pressure control with urapidil.
- The patient underwent a hybrid procedure involving ascending aorta and aortic arch replacement, subclavian artery reconstruction, and endovascular aneurysm repair.
Findings:
- Cardiopulmonary bypass was established via femoral vessels due to the inability to use the right axillary artery.
- The aberrant right subclavian artery presented a unique challenge for standard surgical approaches.
- Bilateral cerebral perfusion was achieved by cannulating the common carotid arteries.
Implications:
- This case underscores the importance of detailed pre-operative imaging in heart transplant recipients with suspected aortic pathology.
- Aberrant vasculature, like the right subclavian artery, requires tailored surgical strategies for cardiopulmonary bypass and aortic repair.
- Successful hybrid repair demonstrates the feasibility of managing complex aortic dissections in the context of prior cardiac transplantation.
