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J Thorac Cardiovasc Surg 2003;126:290-291
© 2003 The American Association for Thoracic Surgery

Brief communication

Intentional delay of surgery for acute type A dissection with stroke

Ikuo Fukuda, MDa, Tomohiro Imazuru, MDb,*

a From the First Department of Surgery, Hirosaki University School of Medicine, Aomori, Japan
b Department of Cardiovascular Surgery, Tsukuba Medical Center Hospital, Tsukuba, Japanb

Received for publication August 23, 2002; accepted for publication September 9, 2002.

* Address for reprints: Ikuo Fukuda, MD, First Department of Surgery, Hirosaki University School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori, 036-8562 Japan
ikuofuku@cc.hirosaki-u.ac.jp

The first 20% of the full text of this article appears below.


Dr Fukuda


Since the brain is sensitive to ischemia-reperfusion injury, management of acute aortic dissection with cerebral infarction is controversial.1 We report on 4 patients with acute aortic dissection complicated by cerebral infarction.

Clinical summary

The clinical course of 4 patients who had simultaneous onset of acute aortic dissection and stroke was reviewed (Table 1). The incidence of cerebral infarction was 8.2% among patients with Stanford type A dissection who were referred for surgery to Tsukuba Medical Center during the past 10 years. Although 1 patient died due to brain herniation, 3 patients successfully underwent reconstruction of the aortic arch in the chronic stage.


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  		TABLE 1. Clinical presentation in 4 patients with complete cerebral infarction and acute aortic dissection

 
PATIENT 1. The patient was a 67-year-old man with coma and left hemiparesis due to acute type A aortic dissection. Computed tomography (CT) of the brain taken 10 hours after the onset revealed right cerebral infarction with swelling of the right . . . [Full Text of this Article]




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