[HSF] Aortic Dissection early after AVR with CABG

[Tohru Asai]

Dear Members
The 73 yo male had underwent AVR(CEP) and double CABG (LITA-LAD, SVG-PDA),
and had shown good recovery. Prior to discharge, we evaluated contrast
enhanced CT to confirm graft patency. The study showed ascending aortic
dissection. Pseudolumen was widely patent from the level of very proximal
ascending to the proximal arch. No clot in the pseudolumen, which occupied
about half the lumen of the mid ascending. Outer dimention of the Aorta was
4.5 to 5.0 cm. Our staff had waited a week to check the size until I came
back from NY. The repeat CT showed the same picture. The patient had never
experienced the dissection-like symptom at all. In OR, there was no sign of
aortic dissection.

What should we do? Operate? Now 3 weeks from the initial surgery.
Any comments are welcome.
-- 
Tohru Asai
Shiga University of Medical Science
Otsu, Japan