[Stanford Type A Aortic Dissection after Off-pump Coronary Artery Bypass Grafting Using Automated Proximal Anastomotic Device;Report of a Case].

ABSTRACT

Operative mortality of Stanford type A aortic dissection( AAD) repair with previous cardiac surgery is high, especially with previous coronary artery bypass grafting. We report an extremely rare case of AAD related to the PAS-Port system. A 68-year-old male patient on dialysis was admitted to our hospital with a diagnosis of AAD. Half a year before he had undergone off-pump coronary artery bypass grafting using PAS-Port system for a proximal anastomosis of a vein graft. Urgent graft replacement of the ascending aorta was performed, and the proximal anastomotic site of the vein graft was attached to the prosthetic graft. Intraoperative investigation revealed that an intimal tear was located on the anastomotic site made by the PAS-Port system. The postoperative course was uneventful and he has been visiting our hospital regularly for dialysis.