[A case report of Stanford type A acute thrombosed aortic dissection complicating cardiac tamponade]

An 85-year-old man was admitted with shock due to cardiac tamponade. Plain computed tomography showed a dilated ascending aorta but did not clearly show an aortic dissection. We performed an emergency operation with median sternotomy without the benefit of findings from enhanced computed tomography and aortography. Soon after the bloody pericardial effusion was decompressed during the operation, bleeding from the ascending aorta occurred. An intimal tear was found in the distal ascending aorta, and the pseudolumen was filled with fresh thrombus. The ascending aorta was replaced. The patient had an uneventful postoperative recovery and was discharged 1 month after the operation. We conclude that patients with Stanford type A acute thrombosed aortic dissection complicating cardiac tamponade should undergo early graft replacement.