Sartipy Ulrik, Malmstedt Jonas, Holm Peter, Owall Anders, Dellgren Göran
Department of Cardiothoracic Surgery and Anesthesiology, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden.
Heart Surg Forum. 2006;9(6):E818-9. doi: 10.1532/HSF982.0061029.
Malperfusion syndrome may complicate the postoperative course in patients who have undergone surgery for aortic dissection. In these cases, open surgery or endovascular intervention may be required. We present a case of postoperative onset of intermittent severe neurological symptoms after surgery for type A aortic dissection. Progressive dissection of the carotid arteries was diagnosed, and treatment options were discussed. A successful aorto-carotid bypass was performed by cardiac and vascular surgeons in collaboration. All neurological symptoms were completely resolved. We advocate a high degree of vigilance for signs of cerebral malperfusion in the intensive care unit. Early intervention can result in a successful outcome, as illustrated by this case report.