Abstract
Case: A 55-year-old man without past medical histories suffering from back pain for two weeks was successfully resuscitated from an 8-min cardiopulmonary arrest (CPA) and was brought to our hospital by ambulance. Computed tomography demonstrated type A acute aortic dissection (AAAD) with brachiocephalic artery occlusion. After admission, Glasgow Coma Scale score improved to E1VTM4, and voluntary movement was noted only in the right limbs. Outcome: The patient underwent emergency grafting of the ascending aorta and innominate artery under deep hypothermic circulatory arrest. After surgery, the patient recovered with mild disorientation and left hemiplegia. Magnetic resonance imaging of the head revealed no large infarction but revealed multiple acute ischemic changes. One year later, the patient demonstrated independent walk and successfully returned to work life. Conclusions: Immediate resuscitation and surgery resulted in good recovery from CPA after AAAD.
Highlights
Type A acute aortic dissection (AAAD) requires emergency surgery as definitive treatment with a mortality rate of more than 40% after onset [1]
Case: A 55-year-old man without past medical histories suffering from back pain for two weeks was successfully resuscitated from an 8-min cardiopulmonary arrest (CPA) and was brought to our hospital by ambulance
Poor prognosis has been reported with cardiopulmonary arrest (CPA) [2], aortic branch occlusion [3] [4] [5]
Summary
Type A acute aortic dissection (AAAD) requires emergency surgery as definitive treatment with a mortality rate of more than 40% after onset [1]. Poor prognosis has been reported with cardiopulmonary arrest (CPA) [2], aortic branch occlusion [3] [4] [5]. [6], severe consciousness disturbance [4], and cerebral vascular disorders (CVD) [4] in the preoperative period. We report a case of AAAD, requiring emergency surgery and recovering after out-of-hospital CPA with good neurological outcome
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