Stroke after Acute Type-A Aortic Dissection Repairment Surgery with Dual Arterial Cannulation: A Case Report

Bakır İ*, Akdoğan B, Yetüt D and Yazıksız N

Department of Cardiovascular Surgery, Istanbul University, Istanbul, Turkey

^*Correspondance to: Ihsan Bakir 

 PDF  Full Text DOI: 10.25107/2474-1647.3610

Abstract

Background and Aim: The severity and extent of the aortic dissection, the patients’ ages and physical conditions, and the surgical team's possibilities identify the case's prognosis. Cannulation strategy in surgery for acute type A aortic dissection is controversial. This article appraised the advantages and drawbacks of the selected cannulation technique in our patient who had a stroke after thriving aortic dissection repairment surgery. Methods: An 83-year-old female diagnosed with hypertension, diabetes mellitus, chronic renal failure and asthma was admitted to our clinic with back and chest pain, hypotension, weak pulse in the left arm and loss of consciousness. She had acute type A aortic dissection on CT angiography imaging and required surgical intervention. We operated on the patient via cardiopulmonary bypass established with dual arterial cannulation by using femoral and subclavian arteries. Results: Supracoronary ascending aorta replacement operation was performed for the patient who had acute type A aortic dissection which was extending from the aortic root to the right brachiocephalic truncus. There was no spontaneous awakening in the postoperative intensive care follow-ups. The patient was consulted by neurology. In the MR imaging, subacute infarcts were observed in the areas supplied by the right middle cerebral artery and posterior cerebral artery. About two months after ascending aortic replacement surgery, the patient died of sepsis and multiple organ failure. Conclusion: Although studies show that dual arterial cannulation technique is advantageous over single arterial cannulation in terms of stroke and mortality, single subclavian or axillary and femoral cannulation can be considered in the foreground in selected patients.

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Cite the article

Bakır İ, Akdoğan B, Yetüt D, Yazıksız N. Stroke after Acute Type-A Aortic Dissection Repairment Surgery with Dual Arterial Cannulation: A Case Report. Clin Surg. 2023; 8: 3610.