Acute Type A Aortic Dissection Involving the Left Main Trunk of the Coronary Artery

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  • Tominaga Ryuji
    Department of Cardiovascular Surgery, Kyushu University Faculty of Medicine
  • Tomita Yukihiro
    Department of Cardiovascular Surgery, Kyushu University Faculty of Medicine
  • Toshima Yosihiro
    Department of Cardiovascular Surgery, Kyushu University Faculty of Medicine
  • Nishimura Yousuke
    Department of Cardiovascular Surgery, Kyushu University Faculty of Medicine
  • Kurisu Kazuhiro
    Department of Cardiovascular Surgery, Kyushu University Faculty of Medicine
  • Morita Shigeki
    Department of Cardiovascular Surgery, Kyushu University Faculty of Medicine
  • Masuda Munetaka
    Department of Cardiovascular Surgery, Kyushu University Faculty of Medicine
  • Yasui Hisataka
    Department of Cardiovascular Surgery, Kyushu University Faculty of Medicine

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  • A Report of Two Successful Cases

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This report describes 2 cases of a type A acute aortic dissection combined with myocardial infarction caused by a retrograde dissection into the left main trunk of the coronary artery. Successful surgical treatments, including the replacement of the ascending aorta, aortic valve resuspension and coronary artery bypass grafting, were performed in both patients, and they recovered well from cardiogenic shock. However, left ventricular function of both patients remained depressed postoperatively, which limited their quality of life. Because no definite method for salvaging infarcted myocardium has yet been established, either more timely surgery or the preoperative placement of a perfusion catheter in the left main coronary artery is mandatory. (Jpn Circ J 1999; 63: 722 - 724)

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