Risk of aortic dissection after aortic valve replacement

Pieters, Frans; Widdershoven, Jos; Gerardy, A.; Geskes, Gijs; Cheriex, E.C.; Wellens, Hein J.J.

doi:10.1016/0002-9149(93)90860-f

Cited by 73 publications

(47 citation statements)

References 22 publications

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“…[32][33][34][35] Given the morbidity and mortality rates associated with iatrogenic aortic dissection, careful assessment is strongly encouraged in patients with unexplained hemodynamic instability or malperfusion syndromes after invasive vascular procedures or surgery (Table 2).…”

Section: Acquired Conditionsmentioning

confidence: 99%

Aortic Dissection: New Frontiers in Diagnosis and Management

2003

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Section: Acquired Conditionsmentioning

confidence: 99%

Aortic Dissection: New Frontiers in Diagnosis and Management

2003

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“…Several investigators reported that dilated ascending aorta, known atherosclerosis, previous coronary bypass surgery, older age, and blood pressure at the time of dissection were risk factors for iatrogenic dissection. 13,14) In the present case, however, the patient was still young, diameter of the ascending aorta was less than 40 mm (Fig. 1), and there was no refractory hypertension at the time of type A dissection onset.…”

Section: Discussionmentioning

confidence: 49%

Case of Sudden Death from Retrograde Type A Dissection Two Days after Surgery for a Type B Dissecting Aneurysm

Hata

Akiyama

Orime

et al. 2014

ATCS

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A 64-year-old man underwent a descending aortic replacement for a chronic type B dissecting aneurysm with left thoracotomy. The patient was weaned from the mechanical ventilator immediately after surgery without any neurological complications. However, on the second post-operative day, he suddenly suffered from cardiopulmonary arrest when talking with his family. Despite 6 hours of cardiopulmonary resuscitation, the patient died. The postmortem examination revealed a 1000 mL blood volume and huge hematoma in the pericardium owing to a retrograde type A dissection, which descended from an intimal laceration between the common carotid and left subclavian arteries that corresponded with aortic cross clamping. We here report a rare case of iatrogenic retrograde type A dissection caused by surgical clamping on the aortic arch 2 days post-surgery.

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“…Preoperative variables include, hypertension, aortic root dilatation, bicuspid aortic valve, connective tissue disorder (Marfan syndrome, vascular Ehlers-Danlos syndrome, Turner syndrome, and Loeys-Dietz syndrome) (5). Any concomitant procedure that needs accomplishment of AVR such as aortic root canuula for cardioplegin, aortotomy site decalcification of aortic ring or aorticvalves, partialor or complete aortic clamping site, accidental trauma to aortic wall by electrocautery, and use of suture with large needle (5-7).…”

Section: Discussionmentioning

confidence: 99%