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Successful surgical repair of aortic dissection presenting with complete heart block
M E Jessen1, V P Horn, D E Weaver
1Department of Surgery, St. Paul Medical Center, Dallas, Texas, USA.
Insights
Acute aortic dissection can cause complete heart block. This case highlights successful surgical repair of type A dissection, though permanent pacing was needed for persistent heart block.
Area of Science:
- Cardiovascular Surgery
- Cardiology
- Thoracic Surgery
Background:
- Acute ascending aortic dissection (type A) is a life-threatening condition.
- Dissection involving the interatrial septum can compromise the atrioventricular node, leading to heart block.
Observation:
- A patient presented with acute type A aortic dissection and complete heart block.
- The dissecting hematoma extended to the interatrial septum near the atrioventricular node.
Findings:
- Emergency surgical repair included ascending aorta grafting, aortic valve replacement, and coronary artery bypass grafting.
- The patient survived the procedure, but complete heart block persisted.
Implications:
- Surgical intervention for acute aortic dissection can be life-saving.
- Persistent complete heart block necessitates permanent pacemaker implantation following aortic dissection repair.
Abstract:
Acute dissection of the ascending aorta can present with complete heart block if the dissecting hematoma involves the interatrial septum near the atrioventricular node. We report a case of acute type A dissection presenting with complete heart block treated with emergency grafting of the ascending aorta, aortic valve replacement, and coronary artery bypass grafting. The patient survived, although complete heart block persisted requiring permanent pacemaker implantation.