Retrograde Cerebral and Coronary Perfusion for Acute Dissection of Stanford Type A with Destruction of the Right Coronary Ostia

Sueda Taijiro

Hayashi Saiho

Nomimura Takayuki

Kurisu Yoshihiro

Orihashi Kazumasa

Shikata Hiroo

Matsuura Yuichiro

Hiroshima Journal of Medical Sciences

[PISSN] 0018-2052

[EISSN] 2433-7668

[NCID] AA00664312

Repair of acute aortic dissection with destruction of the right coronary ostia and aortic valve regurgitation is described. The patient was a 54 year-old female with Marfan syndrome, who was admitted to our hospital for acute dissection with annulo aortic ectasia, accompanied by myocardial ischemia of the inferior wall. Retrograde dissection to the aortic annulus and destruction of the right coronary ostia due to extended dissection were noted. Retrograde coronary infusion through the coronary sinus was conducted during replacement of aortic annulus by the Cabrol method in conjunction with supplementary vein grafting to the right coronary artery. Distal repair was carried out, supported by hypothermic circulatory arrest and retrograde cerebral perfusion through the superior vena caval cannula. Retrograde cerebral and coronary sinus perfusion have been shown to be quite effective for treating patients requiring complex reconstruction of the ascending aorta.

Retrograde cerebral perfusion

Retrograde coronary sinus pefusion

Acute aortic dissection

Medical sciences [ 490 ]

eng

Hiroshima University Medical Press

[ISSN] 0018-2052

[NCID] AA00664312