Prosthetic Repair of the Ascending Aorta in a Patient with Aortic Dissection Type A after Coronary Artery Bypass Grafting (Case Report)

Abstract

Aortic dissection after cardiac surgery is a rare abnormality in patients after prior coronary artery bypass grafting. This abnormality is often accompanied by aortic valve insufficiency, lower extremity malperfusion syndrome and other symptoms.

The aim. To represent a case of correction of aortic dissection type A, with moderate to severe aortic insufficiency and right lower limb malprofusion syndrome in a patient with overweight after previous cardiac surgery.

Materials and methods. A 39-year-old patient was hospitalized with complaints for increased blood pressure, pain of the right lower limb and it malfunction. During the examination, an aortic dissection type A was diagnosed, and the right lower limb malperfusion syndrome was diagnosed.

Results and discussion. Aortic dissection type A combined with aortic insufficiency and lower extremity malperfusion syndrome is a rare abnormality in overweight patients after the previous coronary artery bypass grafting carried out in 2015. There were no descriptions of such cases in the local literature. Aortic prosthetic repair was performed with the formation of Hemiarch distal anastomosis using retrograde cerebral perfusion and femo-femoral shunting.

Conclusion. Prosthetic repair of the ascending aorta with the formation of Hemiarch distal anastomosis and resuspension of the aortic valve using retrograde cerebral perfusion and deep hypothermia, and formation of femo-femoral shunting provided good outcome in patient with aortic dissection, aortic valve insufficient, lower extremities malperfusion syndrome and overweight.