A Case of Acute Stanford Type A Aortic Dissection after Retrosternal Gastric Tube Reconstruction for Esophageal Cancer

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  • Uekihara Kenta
    Department of Cardiovascular Surgery, Japanese Red Cross Kumamoto Hospital
  • Sakaguchi Takeshi
    Department of Cardiovascular Surgery, Japanese Red Cross Kumamoto Hospital
  • Matsukawa Mai
    Department of Cardiovascular Surgery, Japanese Red Cross Kumamoto Hospital
  • Hirayama Ryo
    Department of Cardiovascular Surgery, Japanese Red Cross Kumamoto Hospital
  • Hagio Koji
    Department of Cardiovascular Surgery, Japanese Red Cross Kumamoto Hospital
  • Watanabe Toshiaki
    Department of Cardiovascular Surgery, Japanese Red Cross Kumamoto Hospital
  • Suzuki Ryusuke
    Department of Cardiovascular Surgery, Japanese Red Cross Kumamoto Hospital

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  • 食道癌術後に発症した急性大動脈解離に対する1手術例

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An 80-year-old man presented with a history of retrosternal gastric tube reconstruction for esophageal cancer. He experienced sudden chest pain, and temporarily lost consciousness, before being transferred to our hospital. Contrast-enhanced computed tomography revealed acute Stanford type A aortic dissection and a retrosternal gastric tube. We performed emergency operation using a median sternotomy approach. Before median sternotomy, we detected the gastric tube in the subxiphoid and suprasternal spaces. The anterior and right sides of the gastric tube were dissected bluntly from the posterior surface of the sternum and median sternotomy was performed. The gastric tube was mobilized to the left side and we were able to obtain the usual operative view for ascending aorta graft replacement. Intraoperatively, the gastric tube remained intact and uninjured. The patient was transferred to another hospital for rehabilitation on postoperative day 34.

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