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A Complete Occlusion of Right Coronary Artery Due to Stanford Type A Aortic Dissection - Successful Treatment with Extracorporeal Membrane Oxygenation (ECMO)

We present a patient diagnosed Stanford Type A aortic dissection, who was misdiagnosed as acute myocardial infarction for 5 days. In the surgery, the right coronary ostium was totally occluded, and the right coronary artery (RCA) was bluish from the trunk to branches. The true lumen couldn’t be foun...

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Autores principales: Wang, Yong, Zhu, Zhicheng, Xu, Rihao, Li, Dan, Wang, Tiance, Liu, Kexiang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Sociedade Brasileira de Cirurgia Cardiovascular 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6713360/
https://www.ncbi.nlm.nih.gov/pubmed/31454206
http://dx.doi.org/10.21470/1678-9741-2018-0060
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author Wang, Yong
Zhu, Zhicheng
Xu, Rihao
Li, Dan
Wang, Tiance
Liu, Kexiang
author_facet Wang, Yong
Zhu, Zhicheng
Xu, Rihao
Li, Dan
Wang, Tiance
Liu, Kexiang
author_sort Wang, Yong
collection PubMed
description We present a patient diagnosed Stanford Type A aortic dissection, who was misdiagnosed as acute myocardial infarction for 5 days. In the surgery, the right coronary ostium was totally occluded, and the right coronary artery (RCA) was bluish from the trunk to branches. The true lumen couldn’t be found when we opened the RCA. We had to give up coronary artery bypass grafting (CABG). After a regular surgery of type A aortic dissection, the patient was failed to wean from cardiopulmonary bypass due to the right heart dysfunction. The Extracorporeal membrane oxygenation (ECMO) was instituted. The right ventricular wall motion was gradually improved during the post-operation period. This is the first report of using ECMO to successfully treat a complete occlusion of the right coronary artery due to a Type A aortic dissection. This case demonstrates the value of ECMO in assisting right heart function to ensure stable hemodynamics and myocardial recovery in the type A aortic dissection with coronary involvement.
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spelling pubmed-67133602019-09-03 A Complete Occlusion of Right Coronary Artery Due to Stanford Type A Aortic Dissection - Successful Treatment with Extracorporeal Membrane Oxygenation (ECMO) Wang, Yong Zhu, Zhicheng Xu, Rihao Li, Dan Wang, Tiance Liu, Kexiang Braz J Cardiovasc Surg Case Report We present a patient diagnosed Stanford Type A aortic dissection, who was misdiagnosed as acute myocardial infarction for 5 days. In the surgery, the right coronary ostium was totally occluded, and the right coronary artery (RCA) was bluish from the trunk to branches. The true lumen couldn’t be found when we opened the RCA. We had to give up coronary artery bypass grafting (CABG). After a regular surgery of type A aortic dissection, the patient was failed to wean from cardiopulmonary bypass due to the right heart dysfunction. The Extracorporeal membrane oxygenation (ECMO) was instituted. The right ventricular wall motion was gradually improved during the post-operation period. This is the first report of using ECMO to successfully treat a complete occlusion of the right coronary artery due to a Type A aortic dissection. This case demonstrates the value of ECMO in assisting right heart function to ensure stable hemodynamics and myocardial recovery in the type A aortic dissection with coronary involvement. Sociedade Brasileira de Cirurgia Cardiovascular 2019 /pmc/articles/PMC6713360/ /pubmed/31454206 http://dx.doi.org/10.21470/1678-9741-2018-0060 Text en http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Wang, Yong
Zhu, Zhicheng
Xu, Rihao
Li, Dan
Wang, Tiance
Liu, Kexiang
A Complete Occlusion of Right Coronary Artery Due to Stanford Type A Aortic Dissection - Successful Treatment with Extracorporeal Membrane Oxygenation (ECMO)
title A Complete Occlusion of Right Coronary Artery Due to Stanford Type A Aortic Dissection - Successful Treatment with Extracorporeal Membrane Oxygenation (ECMO)
title_full A Complete Occlusion of Right Coronary Artery Due to Stanford Type A Aortic Dissection - Successful Treatment with Extracorporeal Membrane Oxygenation (ECMO)
title_fullStr A Complete Occlusion of Right Coronary Artery Due to Stanford Type A Aortic Dissection - Successful Treatment with Extracorporeal Membrane Oxygenation (ECMO)
title_full_unstemmed A Complete Occlusion of Right Coronary Artery Due to Stanford Type A Aortic Dissection - Successful Treatment with Extracorporeal Membrane Oxygenation (ECMO)
title_short A Complete Occlusion of Right Coronary Artery Due to Stanford Type A Aortic Dissection - Successful Treatment with Extracorporeal Membrane Oxygenation (ECMO)
title_sort complete occlusion of right coronary artery due to stanford type a aortic dissection - successful treatment with extracorporeal membrane oxygenation (ecmo)
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6713360/
https://www.ncbi.nlm.nih.gov/pubmed/31454206
http://dx.doi.org/10.21470/1678-9741-2018-0060
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