Document Detail

Acute type A aortic dissection and left main coronary artery obstruction detected by transesophageal echocardiography.
MedLine Citation:
PMID:  20676001     Owner:  NLM     Status:  MEDLINE    
A 63-year-old man was admitted with severe chest pain. The electrocardiogram demonstrated ST-segment depression in the anterior and lateral leads suggesting acute anterior myocardial ischemia. Contrast-enhanced thoracic computed tomography performed due to severe back pain showed acute dissection of the descending aorta. Coronary angiography showed normal coronary arteries. Transesophageal echocardiography revealed a Stanford type A aortic dissection involving the left main coronary ostium and causing left main coronary occlusion. The dissected flap caused partial obstruction of the coronary ostium and occasional separation of the lumen, resulting in nonsustained ventricular tachycardia. At emergency operation, the entry of the dissection was seen in the ascending aorta and the dissection extended throughout almost the entire sinus of Valsalva and the left main coronary trunk. The aortic flap was seen in the coronary ostium. Both the right and left coronary arteries were prepared widely and sutured directly to a composite graft. The ascending aorta was replaced with a composite graft through a Bentall procedure. Descending aortic repair was planned for a subsequent operation. The patient was hemodynamically stable for three weeks, but then developed respiratory insufficiency due to severe nosocomial pneumonia and died one month after the operation.
Ahmet Umit Güllü; Zekeriya Nurkalem; Murat Akçar; Mehmet Eren
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Türk Kardiyoloji Derneği arşivi : Türk Kardiyoloji Derneğinin yayın organıdır     Volume:  38     ISSN:  1016-5169     ISO Abbreviation:  Turk Kardiyol Dern Ars     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-08-02     Completed Date:  2010-11-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9426239     Medline TA:  Turk Kardiyol Dern Ars     Country:  Turkey    
Other Details:
Languages:  eng     Pagination:  211-4     Citation Subset:  IM    
Department of Cardiovascular Surgery, Siyami Ersek Cardiovascular Surgery Center, Istanbul, Turkey.
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MeSH Terms
Acute Disease
Aneurysm, Dissecting / radiography*,  surgery,  ultrasonography
Aortic Aneurysm / radiography*,  surgery,  ultrasonography
Echocardiography, Transesophageal
Middle Aged
Surgical Flaps
Tomography, X-Ray Computed

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