ABSTRACT
A 45-year-old man complaining of chest and back pain due to acute aortic dissection was referred to our department. A contrast enhanced computed tomography( CT) scan showed Stanford type B aortic dissection with Kommerell diverticulum and aberrant right subclavian artery. The patient underwent antihypertensive treatment for one month. Despite the successful treatment, CT scan revealed a 5 mm false lumen dilatation in this period. We decided to close the primary entry. The operation was performed through median sternotomy;after establishing cardio-pulmonary bypass, the ostium of the aberrant right subclavian artery( ARSA) was sutured closed and anastomosed the ARSA and right common carotid artery. Total arch replacement was performed using frozen elephant trunk technique. His postoperative course was uneventful.
Subject(s)
Aortic Aneurysm, Thoracic , Aortic Dissection , Blood Vessel Prosthesis Implantation , Cardiovascular Abnormalities , Male , Humans , Middle Aged , Aortic Aneurysm, Thoracic/complications , Aortic Aneurysm, Thoracic/diagnostic imaging , Aortic Aneurysm, Thoracic/surgery , Aortic Dissection/complications , Aortic Dissection/diagnostic imaging , Aortic Dissection/surgery , Subclavian Artery/diagnostic imaging , Subclavian Artery/surgery , Cardiovascular Abnormalities/complications , Cardiovascular Abnormalities/diagnostic imaging , Cardiovascular Abnormalities/surgery , Aorta, Thoracic/diagnostic imaging , Aorta, Thoracic/surgery , Blood Vessel Prosthesis Implantation/methodsABSTRACT
An 83-year-old woman with congestive heart failure due to severe mitral regurgitation was referred to our department. Because acute coronary syndrome was suspected, the patient underwent emergent coronary artery angiography, which showed 75% stenosis of segment 2 and 90% stenosis of segment 11. Subsequently, segment 11 was treated by percutaneous coronary intervention. Additionally, transesophageal echocardiography findings showed a prolapse of P2 due to papillary muscle rupture. After management of heart failure, a scheduled operation was performed under the diagnosis of acute mitral regurgitation due to papillary muscle rupture. Intraoperative findings demonstrated a rupture of the anterior papillary muscle, prolapse of P2, and no evidence of infection. The patient underwent mitral valve repair with artificial chordae through median sternotomy. Her postoperative course was uneventful.