Repair of chronic type 1 dissection in a patient with coronary artery anomaly

doi:10.5606/tgkdc.dergisi.2015.12180

Bahar Temur, Mehmet Kaplan, Tolga Can, Anıl Karaağaç, Hakkı Aydoğan

Department of Cardiovascular Surgery, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey

DOI : 10.5606/tgkdc.dergisi.2015.12180

Although surgical intervention is considered to be the most appropriate therapeutic choice for acute type 1 dissection even in asymptomatic cases, the diameter of ascending aorta is critical for decision in chronic asymptomatic cases. In this article, we report a 50-year-old male case of chronic type 1 dissection with left main coronary artery originating from the right coronary sinus. Acute type 1 dissection probably occurred two months ago and the patient was misdiagnosed with pulmonary edema. During surgery, the dissection flap fenestration at the level of proximal aortic arch, the Bentall procedure with one button re-implantation, and the left anterior descending coronary artery-left internal thoracic artery anastomosis was done. After an uneventful postoperative period, the patient was discharged with full recovery on the 10^th day.

Keywords : Aortic dissection; coronary vessel anomaly; surgery; fenestration

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