Progressive coronary stenosis detected by intraoperative TEE after acute type-A aortic dissection repair: a case report
Abstract Background Acute type-A aortic dissection is a life-threatening condition requiring urgent intervention. Among its complications, coronary malperfusion is particularly fatal. Although rare, coronary artery stenosis after surgical repair is critical yet underrecognized. Case presentation A 7...
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| Format: | Article |
| Language: | English |
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SpringerOpen
2025-07-01
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| Series: | JA Clinical Reports |
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| Online Access: | https://doi.org/10.1186/s40981-025-00802-y |
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| author | Asuka Komatsu Hiroki Tateiwa Kazumasa Orihashi Takashi Kawano |
| author_facet | Asuka Komatsu Hiroki Tateiwa Kazumasa Orihashi Takashi Kawano |
| author_sort | Asuka Komatsu |
| collection | DOAJ |
| description | Abstract Background Acute type-A aortic dissection is a life-threatening condition requiring urgent intervention. Among its complications, coronary malperfusion is particularly fatal. Although rare, coronary artery stenosis after surgical repair is critical yet underrecognized. Case presentation A 77-year-old man underwent emergency aortic arch replacement for acute type-A aortic dissection. Intraoperative transesophageal echocardiography (TEE) initially showed no coronary involvement. However, ST-segment elevation and new hypokinesia appeared post-repair. TEE identified progressive left main coronary artery stenosis. Coronary angiography confirmed severe stenosis, leading to urgent coronary artery bypass grafting. The patient recovered well and was discharged on postoperative day 33. Conclusions This case highlights the importance of intraoperative TEE for early detection of coronary complications following acute type-A aortic dissection repair. Dissection can progress even after aortic replacement surgery and requires vigilance. Careful monitoring and prompt intervention are crucial to optimize the outcome of these rare but life-threatening events. |
| format | Article |
| id | doaj-art-d3d086b52ebb41a591002fc17fc3da3b |
| institution | Kabale University |
| issn | 2363-9024 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | JA Clinical Reports |
| spelling | doaj-art-d3d086b52ebb41a591002fc17fc3da3b2025-08-20T03:45:27ZengSpringerOpenJA Clinical Reports2363-90242025-07-011111510.1186/s40981-025-00802-yProgressive coronary stenosis detected by intraoperative TEE after acute type-A aortic dissection repair: a case reportAsuka Komatsu0Hiroki Tateiwa1Kazumasa Orihashi2Takashi Kawano3Department of Anesthesiology and Intensive Care Medicine, Kochi Medical SchoolDepartment of Anesthesiology and Intensive Care Medicine, Kochi Medical SchoolDepartment of Anesthesiology and Intensive Care Medicine, Kochi Medical SchoolDepartment of Anesthesiology and Intensive Care Medicine, Kochi Medical SchoolAbstract Background Acute type-A aortic dissection is a life-threatening condition requiring urgent intervention. Among its complications, coronary malperfusion is particularly fatal. Although rare, coronary artery stenosis after surgical repair is critical yet underrecognized. Case presentation A 77-year-old man underwent emergency aortic arch replacement for acute type-A aortic dissection. Intraoperative transesophageal echocardiography (TEE) initially showed no coronary involvement. However, ST-segment elevation and new hypokinesia appeared post-repair. TEE identified progressive left main coronary artery stenosis. Coronary angiography confirmed severe stenosis, leading to urgent coronary artery bypass grafting. The patient recovered well and was discharged on postoperative day 33. Conclusions This case highlights the importance of intraoperative TEE for early detection of coronary complications following acute type-A aortic dissection repair. Dissection can progress even after aortic replacement surgery and requires vigilance. Careful monitoring and prompt intervention are crucial to optimize the outcome of these rare but life-threatening events.https://doi.org/10.1186/s40981-025-00802-yAcute type-A aortic dissectionCoronary artery stenosisTransesophageal echocardiography |
| spellingShingle | Asuka Komatsu Hiroki Tateiwa Kazumasa Orihashi Takashi Kawano Progressive coronary stenosis detected by intraoperative TEE after acute type-A aortic dissection repair: a case report JA Clinical Reports Acute type-A aortic dissection Coronary artery stenosis Transesophageal echocardiography |
| title | Progressive coronary stenosis detected by intraoperative TEE after acute type-A aortic dissection repair: a case report |
| title_full | Progressive coronary stenosis detected by intraoperative TEE after acute type-A aortic dissection repair: a case report |
| title_fullStr | Progressive coronary stenosis detected by intraoperative TEE after acute type-A aortic dissection repair: a case report |
| title_full_unstemmed | Progressive coronary stenosis detected by intraoperative TEE after acute type-A aortic dissection repair: a case report |
| title_short | Progressive coronary stenosis detected by intraoperative TEE after acute type-A aortic dissection repair: a case report |
| title_sort | progressive coronary stenosis detected by intraoperative tee after acute type a aortic dissection repair a case report |
| topic | Acute type-A aortic dissection Coronary artery stenosis Transesophageal echocardiography |
| url | https://doi.org/10.1186/s40981-025-00802-y |
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