SURGICAL  APPROACH TO AN ACUTE DISSECTING ANEURYSM OF THE ASCENDING  AORTA IN THE PRESENCE OF AORTIC COARCTATION

SURGICAL APPROACH TO AN ACUTE DISSECTING ANEURYSM OF THE ASCENDING AORTA IN THE PRESENCE OF AORTIC COARCTATION

Yavuz YÖRÜKOĞLU, Afşin YAVERİ, Enver EKİCİ, Coşkun İKİZLER, *Gülümser HEPER

Özel Çağ Hastanesi, Kalp-Damar Cerrahisi Kliniği, ANKARA
^*SSK İhtisas Hastanesi, Kardiyoloji Kliniği, ANKARA

A 20 year-old man was referred to our hospital with severe chest pain and a prelimenary diagnosis of acute dissecting aneurysm of the ascending aorta in the presence of an untreated coarctation of the thoracic aorta. Following stabilization of the patients condition a balloon coarctation angioplasty was performed to reduce afterload and hypertension and to facilitate a femoral arterial cannulation for cardiopulmonary bypass. The patient was taken directly to surgery following this procedure and underwent a replacement of the ascending aorta and bicuspid aortic valve. A resection and graft interposition technique with reinforcement of the distal and proximal aortic stumps ("teflon sandwich reinforcement") was utilized with an excellent result. We review the literature and discuss this rare entity, with special emphasis on the surgical approach, choice of arterial cannulation site and surgical technique.

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