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[Acute aortic dissection after coronary revascularization--a case report]

T Sakurada1, Y Shibata, M Kamada

  • 1Department of Cardiovascular Surgery, Hiraka General Hospital, Akita, Japan.

[Zasshi] [Journal]. Nihon Kyobu Geka Gakkai
|June 1, 1993
PubMed
Summary

Acute aortic dissection is a rare complication following open heart surgery, particularly after aortic perfusion during cardiopulmonary bypass. This case highlights the potential for myonephropathic-metabolic syndrome after repairing acute aortic dissection with limb ischemia.

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Area of Science:

  • Cardiovascular Surgery
  • Vascular Surgery
  • Cardiopulmonary Bypass

Background:

  • A 59-year-old male with coronary artery disease and peripheral artery disease underwent complex surgical procedures.
  • The patient received bypass grafts for both coronary and lower extremity arteries.

Observation:

  • Postoperatively, the patient developed acute kidney injury and subsequently Stanford type A acute aortic dissection.
  • The dissection originated at the site of aortic perfusion during cardiopulmonary bypass.

Findings:

  • Surgical repair of the ascending aorta was performed.
  • Following reperfusion of the femoral artery, hyperkalemia led to cardiac arrest.
  • Hemodialysis stabilized hemodynamics, but the patient succumbed to low cardiac output syndrome.

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Implications:

  • Acute aortic dissection is a critical, albeit rare, complication of cardiopulmonary bypass with aortic perfusion.
  • The case underscores the risk of myonephropathic-metabolic syndrome in patients with acute aortic dissection and limb ischemia.
  • This presentation emphasizes the need for vigilance regarding aortic complications after cardiac surgery.