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J Thorac Cardiovasc Surg 2007;134:1349-1350
© 2007 The American Association for Thoracic Surgery

Brief Communication

Periaortic glue application may prevent fatal aortic rupture in nonoperable patients with acute type A aortic dissection

Rachid Zegdi, MD, PhDa,b,*, Brahim Amahzoune, MDa, Paul Achouh, MDa,b, Christian Latrémouille, MD, PhDa,b, Alain Deloche, MDa,b, Jean-Noël Fabiani, MDa,b

a Assistance Publique-Hôpitaux de Paris, Service de Chirurgie Cardio-Vasculaire, Hôpital Européen Georges Pompidou, Paris, France
b Université René Descartes, Paris, France.

Received for publication March 8, 2007; revisions received March 27, 2007; accepted for publication April 19, 2007.

* Address for reprints: Rachid Zegdi, MD, PhD, Hôpital Européen Georges Pompidou, Service de Chirurgie Cardiovasculaire, 20, rue Leblanc, 75908 Paris, France. (Email: rzegdi@hotmail.com).

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

Acute type A aortic dissection is a condition requiring emergency surgery. However, surgical intervention is controversial in concomitant stroke. We report a novel approach that prevented fatal aortic rupture in a patient with acute type A dissection with major stroke for whom the surgical cure was intentionally delayed.

Clinical Summary

A 65-year-old woman was hospitalized for right hemiplegia and aphasia rapidly complicated by a comatose state. Initial evaluation revealed temporal ischemic stroke and acute type A aortic dissection (Figure 1, A and B). It was decided to delay surgery. Circulatory shock developed owing to cardiac tamponade. It was then decided to evacuate the pericardial effusion through a median sternotomy and try to limit the risk of rupture by external gluing of the aorta. Inspection did not show any active bleeding. Manipulation of . . . [Full Text of this Article]






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