How to Cite
Abstract
Abdurakhmanov A.A., Obeid M.A., Ehrlich M.
Iatrogenic aortic dissection (IAD) is a very rare but dangerous complication, which can occur during or after open cardiac surgery, complex percutaneous coronary intervention (PCI), thoracic endovascular aortic aneurysm repair (TEVAR) or transaortic valve replacement (TAVR). According to literature, IAD is observed three times more frequently during off pump (OPCAB) than conventional coronary bypass grafting (CABG). It is also associated with a higher mortality and represents a huge challenge to all cardiovascular professionals including cardiac surgeons who encounter this clinical outcome. Here we present a case of intraoperative Stanford type A aortic dissection during off-pump coronary artery bypass.
KeyWords: Aortic dissection, iatrogenic aortic dissection, type A aortic dissection, Dissection of the thoracic aorta, Stanford classification.
ІНТРАОПЕРАЦІЙНЕ РОЗШАРУВАННЯ АОРТИ ТИПУ А (клінічний випадок)
Абдурахманов А.А., Обейд М.А., Ерліх М.
Ятрогенна аортальна диссекція (Яад) - дуже рідкісне, але небезпечне ускладнення, яке може виникати під час або після операції на відкритому серці, комплексних чрескожних коронарних інтервенцій, реконструктивних втручань при аневризмах аорти або при протезуванні аортального клапана. Згідно з літературними даними Яад спостерігається в три рази частіше при коронарного шунтування на працюючому серці, ніж при звичайному коронарного шунтування. Розшарування аорти також асоціюється з більш високою смертністю і являє собою певний виклик для кардіологів та кардіохірургів, які безпосередньо стикаються з цим клінічним ускладненням. У даній публікації ми представляємо випадок диссекции аорти типу А по Стенфорду, що виникла интраоперационно під час операції аорто-коронарного шунтування на працюючому серці.
Ключові слова: диссекція аорти, ятрогенное розсічення аорти, розсічення аорти типу А, розсічення грудної аорти, класифікація Стенфорда
ИНТРАОПЕРАЦИОННОЕ РАССЛОЕНИЕ АОРТЫ ТИПА А (клинический случай)
Абдурахманов А.А., Обейд М.А., Эрлих М.
Ятрогенная аортальная диссекция (ЯАД) - очень редкое, но опасное осложнение, которое может возникать во время или после операции на открытом сердце, комплексных чрескожных коронарных интервенций, реконструктивных вмешательств при аневризмах аорты или при протезировании аортального клапана. Согласно литературным данным ЯАД наблюдается в три раза чаще при коронарном шунтировании на работающем сердце, нежели при обычном коронарном шунтировании. Расслоение аорты также ассоциируется с более высокой смертностью и представляет собой определенный вызов для кардиологов и кардиохирургов, которые непосредственно сталкиваются с этим клиническим осложнением. В данной публикации мы представляем случай диссекции аорты типа А по Стенфорду, возникшей интраоперационно во время операции аорто-коронарного шунтирования на работающем сердце.
Ключевые слова: диссекция аорты, ятрогенное рассечение аорты, рассечение аорты типа А, рассечение грудной аорты, классификация Стэнфорда
References
Buffolo, E., Branco, J.N., Gerola, L.R., Aguiar, L.F., Teles, C.A., Palma, J.H., Catani, R. (2006). Off-pump myocardial revascularization: critical analysis of 23 years’ experience in 3,866 patients. Ann ThoracSurg, 81(1):85-9.
Chavanon, O., Carrier, M., Cartier, R., Hebert, Y., Pellerin, M., Page, P., Perrault, L.P. (2001). Increased incidence of acute ascending aortic dissection with off-pump aortocoronary bypass surgery? Ann ThoracSurg, 71(1):117-21.
Hagl, C., Ergin, M.A., Galla, J.D., Spielvogel, D., Lansman, S., Squitieri, R.P., Griepp, R.B. (2000). Delayed chronic type A dissection following CABG: implications for evolving techniques of revascularization. J Card Surg,15(5):362-7.
Hagl, C., Griepp, R.B. (2001). Aortocoronary bypass surgery and ascending aortic dissection: letter 1. Ann ThoracSurg, 72 (4):1444-6.
Jan, D., Schmitto, Aron, F., Popov,, Kasim, O., Coskun,, Masoud M. (2010). Morphological Investigations: Type A Aortic Dissection Ann ThoracCardiovascSurg, Vol. 16, No. 5
Leontyev, S., Borger, M.A., Legare, J.F., Merk, D., Hahn, J., Seeburger, J. (2012). Iatrogenic type A aortic dissection during cardiac procedures: early and late outcome in 48 patients. Eur J CardiothoracSurg, 41(3):641–6.
Murphy, D.A., Craver, J.M., Jones, E.L., Bone, D.K., Guyton, R.A., Hatcher, C.R. (1983). Jr. Recognition and management of ascending aortic dissection complicating cardiac surgical operations. JThoracCardiovascSurg, 85(2):247-56.
Prabhakar, A.M., Le TQ, Abujudeh, H.H., Raja, A.S. (2015). Incidental findings and recommendations are common on ED CT angiography to evaluate for aortic dissection. Am J Emerg Med, Nov. 33 (11):1639-41.
RızaTürköz, M.D., OnerGulcan, M.D., LeventOguzkurt, M.D., EsraCalıskan, M.D., AydaTurkoz, M.D. (2006). Successful Repair of Iatrogenic Acute Aortic Dissection With Cerebral Malperfusion. Ann ThoracSurg, 81:345–7.
Ruchat, P., Hurni, M., Stumpe, F., Fischer, A.P., von Segesser, L.K. (1998). Acute ascending aortic dissection complicating open heart surgery: cerebral perfusion defines the outcome. Eur J CardiothoracSurg,14(5):449-52.
Stanger, O., Schachner, T., Gahl, B., Oberwalder, P., Englberger, L., Thalmann, M. (2013). Type A aorticdissection after nonaorticcardiacsurgery. Circulation. 128(15):1602–11.
Still, R.J., Hilgenberg, A.D., Akins, C.W., Daggett, W.M., Buckley, M.J. (1992). Intraoperative aortic dissection. Ann ThoracSurg, 53(3):374-80.
Tabry, I., Costantini, E., Reyes, E., Tamim, W., Habal, S., Hughes, L. (2003). Early postoperative acute aortic dissection, the leading cause of sudden death after cardiac surgery? Critical role of the computed tomography scan. Heart Surg Forum, 6(5):382-6.
Ramadan. (2016). Iatrogenic aortic dissection after minimally invasive aortic valve replacement: a case report Journal of Cardiothoracic Surgery, 11:136.
"Inter Collegas" is an open access journal: all articles are published in open access without an embargo period, under the terms of the CC BY-NC-SA (Creative Commons Attribution ‒ Noncommercial ‒ Share Alike) license; the content is available to all readers without registration from the moment of its publication. Electronic copies of the archive of journals are placed in the repositories of the KhNMU and V.I. Vernadsky National Library of Ukraine.
Copyright Agreement
1. This Agreement on the transfer of rights to use the work from the Co-authors to the publisher (hereinafter the Agreement) is concluded between all the Co-authors of the work, represented by the Corresponding Author, and Kharkiv National Medical University (hereinafter the University), represented by an authorized representative of the Editorial Board of scientific journals (hereinafter the Editorial Board).
2. This Agreement is an accession agreement within the meaning of clause 1 of Article 634 of the Civil Code of Ukraine: that is, a contract, "the terms of which are established by one of the parties in forms or other standard forms, which can be concluded only by joining the other party to the proposed contract as a whole. The other party cannot offer its terms of the contract." The party that established the terms of this contract is the University.
3. If there is more than one author, the authors choose the Corresponding Author, who communicates with the Editorial Board on his own behalf and on behalf of all Co-authors regarding the publication of a written work of a scientific nature (article or review, hereinafter referred to as the Work).
4. The contract begins from the moment of submission of the manuscript of the Work by the Corresponding Author to the Editorial Board, which confirms the following:
4.1. all Co-authors of the Work are familiar with and agree with its content, at all stages of reviewing and editing the manuscript and the existence of the published Work;
4.2. all Co-authors of the Work are familiar with and agree to the terms of this Agreement.
5. The published Work is in electronic form in public access on the websites of the University and any websites and electronic databases in which the Work is posted by the University and is available to readers under the terms of the "Creative Commons" license (Attribution NonCommercial Sharealike 4.0 International)" or more free licenses "Creative Commons 4.0".
6. The Corresponding Author transfers, and the University receives, the non-exclusive property right to use the Work by placing the latter on the University's websites for the entire term of copyright. The University participates in the creation of the final version of the Work by reviewing and editing the manuscript of the article or review provided to the Editorial Board by the Corresponding Author, translating the Work into any languages. For the participation of the University in the finalization of the Work, the Co-authors agree to pay the invoice issued to them by the University, if such payment is provided by the University. The size and procedure of such payment are not the subject of this contract.
7. The University has the right to reproduce the Work or its parts in electronic and printed forms, to make copies, permanent archival storage of the Work, distribution of the Work on the Internet, repositories, scientometric databases, commercial networks, including for monetary compensation from third parties.
8. The co-authors guarantee that the manuscript of the Work does not use works whose copyright belongs to third parties.
9. The authors of the Work guarantee that at the time of submission of the manuscript of the Work to the Editorial Board, the property rights to the Work belong only to them, neither in whole nor in part have they been transferred to anyone (not alienated), they are not the subject of a lien, litigation or claims by third parties.
10. The Work may not be posted on the University's website if it violates a person's right to the privacy of his personal and family life, harms public order and health.
11. The work may be withdrawn by the Editorial Board from the University websites, libraries and electronic databases where it was placed by the Editorial Board, in cases of detection of violations of the ethics of the authors and researchers, without any compensation for the losses of the Co-authors. At the time of submission of the manuscript to the Editorial Board and all stages of its editing and review, the manuscript must not have already been published or submitted to other editorial offices.
12. The right transferred under this Agreement extends to the territory of Ukraine and foreign countries.
13. The rights of Co-authors include the requirement to indicate their names on all copies of the Work or during any public use or public mention of the Work; the requirement to preserve the integrity of the Work; legal opposition to any distortion or other encroachment on the Work, which may harm the honor and reputation of the Co-authors.
14. Co-authors have the right to control their personal non-property rights by familiarizing themselves with the text (content) and form of the Work before its publication on the University's website, when transferring it to a printing company for reproduction or when using the Work in other ways.
15. The Co-authors, in addition to the property rights not transferred under this Agreement and taking into account the non-exclusive nature of the rights transferred under this Agreement, retain the property rights to finalize the Work and to use certain parts of the Work in other works created by the Co-authors.
16. The Co-authors are obliged to notify the Editorial Board of all errors in the Work, discovered by them independently after the publication of the Work, and to take all measures to eliminate such errors as soon as possible.
17. The University undertakes to indicate the names of the Co-authors on all copies of the Work during any public use of the Work. The list of Co-authors may be shortened according to the rules for the formation of bibliographic descriptions determined by the University or third parties.
18. The University undertakes not to violate the integrity of the Work, to agree with the Corresponding Author on all changes made to the Work during processing and editing.
19. In case of violation of their obligations under this Agreement, its parties bear the responsibility defined by this Agreement and the current legislation of Ukraine. All disputes under the Agreement are resolved through negotiations, and if the negotiations do not resolve the dispute – in the courts of the city of Kharkiv.
20. The parties are not responsible for the violation of their obligations under this Agreement, if it occurred through no fault of theirs. The party is considered innocent if it proves that it has taken all measures dependent on it for the proper fulfillment of the obligation.
21. The Co-authors are responsible for the truthfulness of the facts, quotes, references to legislative and regulatory acts, other official documentation, the scientific validity of the Work, all types of responsibility to third parties who have claimed their rights to the Work. The co-authors reimburse the University for all costs caused by claims of third parties for infringement of copyright and other rights to the Work, as well as additional material costs related to the elimination of identified defects.