[A case of acute aortic dissection associated with myxedema]

A 53-year-old female, who had been severe hypothyroidism for about ten years, was admitted Stanford type A acute aortic dissection. The replacement of ascending aorta with a composite graft and coronary artery bypass grafting were performed immediately. During the post operative period, many complications occurred including delayed awakening from anesthesia, paralytic ileus, colon perforation, hyperbilirubinemia, pulmonary edema, cerebral hemorrhage and bacterial endocarditis. In this case, intravenous administration of steroid and thyroid hormone was effective to keep hormone level in the normal range although enteral administration was ineffective. It was suggested that early active supplement therapy is mandatory to prevent postoperative complications.