Iatrogenic Acute Type A Aortic Dissection following Elective Cardiopulmonary Bypass

Pierre Huette; Christophe Beyls; Mathieu Guilbart; Guillaume Haye; Jérémie Vial; Gilles Touati; Yazine Mahjoub; Osama Abou-Arab

doi:10.1055/s-0040-1715124

AORTA, Table of Contents

CC BY 4.0 · Aorta (Stamford) 2020; 08(05): 155-158
DOI: 10.1055/s-0040-1715124

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Iatrogenic Acute Type A Aortic Dissection following Elective Cardiopulmonary Bypass

Pierre Huette

¹Department of Anesthesia and Critical Care, Cardiac Thoracic Vascular and Respiratory Intensive Care Unit, Amiens University Medical Center, 1 rue du Professeur Christian Cabrol, Amiens, France

,

Christophe Beyls

¹Department of Anesthesia and Critical Care, Cardiac Thoracic Vascular and Respiratory Intensive Care Unit, Amiens University Medical Center, 1 rue du Professeur Christian Cabrol, Amiens, France

,

Mathieu Guilbart

¹Department of Anesthesia and Critical Care, Cardiac Thoracic Vascular and Respiratory Intensive Care Unit, Amiens University Medical Center, 1 rue du Professeur Christian Cabrol, Amiens, France

,

Guillaume Haye

¹Department of Anesthesia and Critical Care, Cardiac Thoracic Vascular and Respiratory Intensive Care Unit, Amiens University Medical Center, 1 rue du Professeur Christian Cabrol, Amiens, France

,

Jérémie Vial

³Radiologic Department, Amiens University Medical Center, 1 rue du Professeur Christian Cabrol, Amiens, France

,

Gilles Touati

²Cardiac surgery Department, Amiens University Medical center, 1 rue du Professeur Christian Cabrol, Amiens, France

,

Yazine Mahjoub

¹Department of Anesthesia and Critical Care, Cardiac Thoracic Vascular and Respiratory Intensive Care Unit, Amiens University Medical Center, 1 rue du Professeur Christian Cabrol, Amiens, France

,

Osama Abou-Arab

¹Department of Anesthesia and Critical Care, Cardiac Thoracic Vascular and Respiratory Intensive Care Unit, Amiens University Medical Center, 1 rue du Professeur Christian Cabrol, Amiens, France

› Author Affiliations

Abstract

We report a 62-year-old woman who was scheduled for an elective Tirone David valve sparing aortic root replacement under cardiopulmonary bypass. Within the next few hours, the patient developed bilateral acute ischemia of both lower limbs. A thoracic and abdominopelvic computed tomography scan showed acute Type A aortic dissection with a perforation at the brachiocephalic arterial trunk and a complete malperfusion of the inferior mesenteric and iliac arteries.

Keywords

cardiopulmonary bypass - iatrogenic acute aortic dissection - lower limb ischemia

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References

References
1 Rylski B, Hoffmann I, Beyersdorf F. et al. Iatrogenic acute aortic dissection type A: insight from the German Registry for Acute Aortic Dissection Type A (GERAADA). Eur J Cardiothorac Surg 2013; 44 (02) 353-359 , discussion 359
2 Narayan P, Angelini GD, Bryan AJ. Iatrogenic intraoperative type A aortic dissection following cardiac surgery. Asian Cardiovasc Thorac Ann 2015; 23 (01) 31-35
3 Still RJ, Hilgenberg AD, Akins CW, Daggett WM, Buckley MJ. Intraoperative aortic dissection. Ann Thorac Surg 1992; 53 (03) 374-379 , discussion 380
4 Shea NJ, Polanco AR, D’Angelo A, Bethancourt CN, Sanchez J, George I. et al. Improving Outcomes of Iatrogenic Type A Aortic Dissection during Cardiac Surgery. Aorta (Stamford) 2019; 7 (04) 115-120
5 Januzzi JL, Sabatine MS, Eagle KA. ,et al; International Registry of Aortic Dissection Investigators. Iatrogenic aortic dissection. Am J Cardiol 2002; 89 (05) 623-626
6 Li J, Guan X, Gong M, Wang X, Zhang H. Iatrogenic acute aortic dissection induced by off-pump coronary artery bypass grifting: A case report and review of the literature. Medicine (Baltimore) 2017; 96 (51) e9206